Outcomes of headless screw fixation for coronal hamate fractures

Abstract

Aim: The aim of this study is to clarify the surgical technique and to evaluate postoperative outcomes of patients who underwent open reduction and internal fixation (ORIF) with headless screws for the coronal hamate fractures. Material and Method: A retrospective evaluation was performed on a total of 9 patients who underwent ORIF with headless screws for the coronal hamate fracture between 2018 and 2021. Demographic information, surgical details, and clinical follow-up data were systematically collected. Postoperative clinical assessments were carried out using the Michigan Hand Outcome Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Results: The mean age at surgery was 37 years (range: 18-49), and the mean follow-up period was 34 months (range: 24-50). Among the 9 patients with coronal hamate fractures, 5 experienced fractures and/or dislocations involving the 4th and/or 5th metacarpal bones. The median overall MHQ and DASH scores were 76.2 (range: 52.5-97.9, IQR: 68.45-83.95) and 6.7 (range: 0-35, IQR: 1.65-10), respectively. The follow-up X-rays revealed favorable healing of the fractures. Conclusion: Coronal hamate fracture fixation can be effectively managed through fixation with headless screws. It is essential to address both coronal hamate fractures and any accompanying metacarpal fractures/dislocations to ensure optimal hand function. Mid-term follow-ups have demonstrated satisfactory outcomes.