title: Surgical excision of ununited hook of hamate fractures via the carpal tunnel approach.
abstract: BACKGROUND
  Direct excision of a symptomatic ununited hook of hamate fracture is the gold standard, most frequently via a Guyon space approach. The open carpal tunnel approach is another option, which has not previously been commonly considered and not reported in a peer review journal. Our study aims to highlight the carpal tunnel approach as a successful technique in a consecutive series of ununited hook of hamate fractures.
  
  
  METHODS
  Seven patients (all male and mean age 30.7 years) were reviewed with symptomatic ununited fractures following a period of cast immobilization. All the patients operated on underwent excision of the hook of hamate fragment via the open carpal tunnel approach.
  
  
  RESULTS
  All patients successfully returned to their pre-injury level of functioning after 8-12 weeks and there were no complications.
  
  
  CONCLUSIONS
  Our study highlights the open carpal tunnel approach as a successful technique for open excision of symptomatic ununited hook of hamate fractures, because of its familiarity, ease of performance, excellent visualization and low morbidity. Level of Evidence IV Case Series.
authors.affiliation: Medway Maritime Hospital, Kent, UK.
authors.forename: A R
authors.initials: AR
authors.lastname: Tolat
authors.affiliation: Medway Maritime Hospital, Kent, UK. Electronic address: drjoelhumphrey@aol.com.
authors.forename: J A
authors.initials: JA
authors.lastname: Humphrey
authors.affiliation: Medway Maritime Hospital, Kent, UK.
authors.forename: P D
authors.initials: PD
authors.lastname: McGovern
authors.affiliation: King's College Hospital, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Compson
mesh_terms: D000328:Adult; D050824:Carpal Joints / Q000503:physiopathology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods; D005599:Fractures, Ununited / Q000601:surgery*; D051225:Hamate Bone / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007103:Immobilization; D008297:Male; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: Carpal tunnel approach; Hook of hamate fracture