Dorsal Oblique Hamate Fracture
Occasionally, a dorsal oblique hamate fracture will occur in association with a dorsal dislocation of the fifth metacarpal base. This fracture configuration renders the fracture- dislocation unstable. Routine posteroanterior, lateral, and oblique x-ray views of the hand should be obtained ((Figs. 14-1 A) (Figs. 14-1 B) Figs. 14-1 C). An anteroposterior full supination view and oblique views, especially a 30 Degrees pronated lateral view (Fig. 14-1 C), may better delineate the fracture and the amount of displacement. Ulnar nerve motor function should be assessed carefully before and after surgery because of the proximity of the deep motor branch to the ulnar side of the hamate. A dorsal incision is used over the metacarpal hamate joint.