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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hairline Fracture, Posteriorly Dislocated Hamate And 4th Metacarpal. On Cast. Adviced Orif To Be Done To Capitate Move Posteriorly. Right Treatment?

I want to ask which has a good prognosis. I have a hairline fracture and posteriorly dislocated hamate and 4th metacarpal. Its conventionally corrected thru close reduction and immobilize thru cast. After two weeks, i have follow up check up and was refferred to an orthosurgeon.... He told me that it has to be screwed and an orif must be done, i hesitated because when i ask him whats the purpose of the orif he told me that the capitate move posteriorly... I just like to ask if this is right?
Wed, 3 Jul 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.
Generally, undisplaced hairline fractures usually respond well to conservative line of management by plaster cast.
Dislocated capitate bone if not reduced properly will lead to "Carpal instability" over a period of time. This could be the reason why the orthosugeon might have offered you ORIF.
A CT scan / MRI will provide accurate information on the extent of injury to the carpal bones and the corresponding ligaments.
Hope this helps
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Hairline Fracture, Posteriorly Dislocated Hamate And 4th Metacarpal. On Cast. Adviced Orif To Be Done To Capitate Move Posteriorly. Right Treatment?

Hi, thanks for writing to HCM. Generally, undisplaced hairline fractures usually respond well to conservative line of management by plaster cast. Dislocated capitate bone if not reduced properly will lead to Carpal instability over a period of time. This could be the reason why the orthosugeon might have offered you ORIF. A CT scan / MRI will provide accurate information on the extent of injury to the carpal bones and the corresponding ligaments. Hope this helps