Imaging of hamate bone fractures in conventional X-rays and high-resolution computed tomography. An in vitro study.
OBJECTIVE
To examine the ability to image fractures of the body and hook of the hamate bone in conventional X-rays and high-resolution computed tomography (HR-CT).


METHODS
In an in vitro experiment using 18 cadaver hands, the hamate bone was fractured at different places. Before and after fracture, conventional X-rays were taken in different planes (anteroposterior, lateral, oblique, and carpal tunnel), and HR-CT was performed with 2-mm layer thickness in the axial, sagittal, and coronal plane.


RESULTS
Taking into account all the conventional X-ray projections applied, the in vivo experiment revealed a sensitivity of 72.2%, a specificity of 88.8%, and an accuracy of 80.5%. For the HR-CT, the sensitivity was 100%, the specificity was 94.4%, and the accuracy was 97.2%.


CONCLUSIONS
Fractures of the body and hook of the hamate cannot always be detected with certainty in the conventional X-ray image, even if different projectional planes are used. The HR-CT is the imaging procedure of choice for further clarification, and an axial or sagittal plane should be selected.
Andresen
R
R
Department of Diagnostic Radiology and Nuclear Medicine, Behring Municipal Hospital, Free University of Berlin, Germany.
Radmer
S
S
Sparmann
M
M
Bogusch
G
G
Banzer
D
D
D000328:Adult; D000368:Aged; D002102:Cadaver; D002348:Carpal Bones / Q000000981:diagnostic imaging* / Q000293:injuries*; D005188:False Negative Reactions; D005189:False Positive Reactions; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006230:Hand Injuries / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*