TY - JOUR
T1 - Return to Play and Complications After Hook of the Hamate Fracture Surgery
AU - Bansal, Anchal
AU - Carlan, Douglas
AU - Moley, John
AU - Goodson, Heather
AU - Goldfarb, Charles A.
N1 - Publisher Copyright:
© 2017 American Society for Surgery of the Hand
PY - 2017/10
Y1 - 2017/10
N2 - Purpose The purpose of this study was to evaluate the efficacy of hook of the hamate excision for fracture in a large cohort of patients to better understand recovery time and complications. Methods We retrospectively reviewed the medical records of patients treated with surgical excision for hook of the hamate fractures at 2 different centers. We collected information on demographics, clinical presentation, and postoperative complications. Continuous outcome variables included time to surgery, return to play, and return to activity. Results Our cohort of 81 patients had a median age of 22 years and was composed of 74 athletes including 57 baseball players and 8 golfers. The median time to return to play was 6 weeks (range, 1–36 weeks) after surgery; 11 patients (14%) had a return at 12 weeks or longer. Seventy-eight patients returned to preinjury activity levels. Twelve patients with a full recovery continued to experience some level of intermittent, nonspecific pain in the affected hand, although this was not severe enough to require additional treatment. We observed a 25% incidence of postoperative complications with the majority consisting of transient ulnar nerve dysfunction. Complications were more common among nonathletes, those presenting with nonunions, and those experiencing longer intervals between injury and surgery. Conclusions In most cases, surgical excision as treatment for hook of the hamate fractures is safe and allows a relatively rapid return to play. However, we found a higher incidence of complications, including transient ulnar nerve dysfunction, than has been previously reported. In addition, there is a group of patients with delayed return to play and continued discomfort after surgery. These findings should inform the discussion with surgical candidates. Type of study/level of evidence Therapeutic IV.
AB - Purpose The purpose of this study was to evaluate the efficacy of hook of the hamate excision for fracture in a large cohort of patients to better understand recovery time and complications. Methods We retrospectively reviewed the medical records of patients treated with surgical excision for hook of the hamate fractures at 2 different centers. We collected information on demographics, clinical presentation, and postoperative complications. Continuous outcome variables included time to surgery, return to play, and return to activity. Results Our cohort of 81 patients had a median age of 22 years and was composed of 74 athletes including 57 baseball players and 8 golfers. The median time to return to play was 6 weeks (range, 1–36 weeks) after surgery; 11 patients (14%) had a return at 12 weeks or longer. Seventy-eight patients returned to preinjury activity levels. Twelve patients with a full recovery continued to experience some level of intermittent, nonspecific pain in the affected hand, although this was not severe enough to require additional treatment. We observed a 25% incidence of postoperative complications with the majority consisting of transient ulnar nerve dysfunction. Complications were more common among nonathletes, those presenting with nonunions, and those experiencing longer intervals between injury and surgery. Conclusions In most cases, surgical excision as treatment for hook of the hamate fractures is safe and allows a relatively rapid return to play. However, we found a higher incidence of complications, including transient ulnar nerve dysfunction, than has been previously reported. In addition, there is a group of patients with delayed return to play and continued discomfort after surgery. These findings should inform the discussion with surgical candidates. Type of study/level of evidence Therapeutic IV.
KW - Hook of hamate
KW - complications
KW - fractures
KW - recovery time
UR - http://www.scopus.com/inward/record.url?scp=85028333034&partnerID=8YFLogxK
U2 - 10.1016/j.jhsa.2017.06.108
DO - 10.1016/j.jhsa.2017.06.108
M3 - Article
C2 - 28844776
AN - SCOPUS:85028333034
SN - 0363-5023
VL - 42
SP - 803
EP - 809
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
IS - 10
ER -