A novel hamatometacarpal fracture-dislocation classification system based on CT scan

Abstract

Purpose: The purpose of this study was to devise a novel classification of a hamatometacarpal fracture-dislocation based on the preoperative computed tomography (CT) and plain radiography that provided more information to surgeons regarding appropriate treatment methods. Materials and methods: Twenty-one patients with a hamatometacarpal fracture-dislocation were enrolled in this study. The classification scheme devised for hamatometacarpal fracture-dislocation is summarised as follows: type I - a simple dislocation; type IIA - a dislocation with the fourth metacarpal base intra-articular fracture; type IIB - a dislocation with a dorsal hamate fracture of less than one-third of the articular surface; and type III - a dislocation with a dorsal hamate fracture of more than one-third of the articular surface. Results: Type I injury was treated conservatively after closed reduction. Type IIA and IIB injuries were treated by percutaneous K-wire fixation. Type III injury was treated by open reduction and internal fixation. All injuries were well managed in both clinical and radiographic evaluations, without apparent complications. Conclusion: The novel classification system for hamatometacarpal fracture-dislocation can be used to establish guidelines for appropriate treatment. © 2012 Elsevier Ltd. All rights reserved.