Other signs that are visible in the anteroposterior view are loss of cortical density at the base of the hook and even absence of the hook. In some hook fractures, the so-called "ring sign" may be disrupted. The overlapping of the hook of the hamate and its body is known as the "ring sign," a normal finding in the anteroposterior view. Initial radiographs include anteroposterior and lateral wrist views. This phenomenon is the result of flexor tendons deforming forces attached at the fracture site. Pull test: in the hook of the hamate fractures, active flexion of distal interphalangeal joints of the ring and small finger may cause pain. Fourth and fifth metacarpal pain is related to hamate injuries even metacarpal deformity may be an indirect sign of the body of the hamate fracture. Weakened grip strength is typical. Grasp maneuvers provoke pain along the ulnar side of the wrist. Swelling and tenderness over the dorsal ulnar wrist frequently present in hamate body fractures. Delayed medical consultation is not uncommon.īecause of its relation to higher energy trauma and associated injuries, the body of the hamate fracture diagnosis tends to be acute. Paresthesias along the ring and small finger are relatively common in chronic disease. Chronic wrist pain is common with a hook of the hamate fracture, with tenderness and exquisite pain over the hypothenar area. Suspicion should be high in young athletes with chronic pain along the ulnar aspect of the wrist. Though clinical findings may be vague and unspecific, there are some tests that are useful if a hamate fracture is suspected.
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