What is the fracture similar to a scaphoid fracture but located on the opposite side of the hand?

From the Guidelines

The fracture similar to a scaphoid fracture but located on the opposite side of the hand is a hamate fracture. The hamate bone is a carpal bone located on the ulnar side (pinky finger side) of the wrist, whereas the scaphoid is on the radial side (thumb side) 1. Hamate fractures typically occur in two patterns: hook of hamate fractures and body fractures. These injuries commonly result from direct trauma, such as falling on an outstretched hand, or from repetitive stress in activities involving gripping implements like golf clubs, baseball bats, or tennis racquets. Symptoms include pain on the ulnar side of the wrist, weakness in grip strength, and tenderness over the hamate bone.

Key Points

• Diagnosis often requires specialized imaging as these fractures can be difficult to visualize on standard X-rays; CT scans are frequently needed for confirmation 1.
• Treatment depends on the fracture type and displacement, ranging from immobilization with a cast for stable fractures to surgical intervention for displaced fractures or those involving the hook of the hamate 1.
• The management of hamate fractures should prioritize minimizing morbidity, mortality, and optimizing quality of life, considering the potential for long-term complications such as arthritis or chronic pain 1.

Considerations

• The choice between conservative and surgical management should be based on the individual patient's condition, the severity of the fracture, and the presence of any associated injuries 1.
• Recent studies, such as those published in the Journal of the American College of Radiology, emphasize the importance of accurate diagnosis and appropriate treatment to prevent long-term sequelae 1.

From the Research

Fracture Similar to Scaphoid Fracture

The fracture similar to a scaphoid fracture but located on the opposite side of the hand is the triquetral fracture.

• The triquetrum is the second most commonly fractured carpal bone, comprising 15-18% of all carpal bone fractures 2.
• Triquetral fractures are frequently caused by impaction of the ulnar wrist after a fall on an outstretched hand or by avulsion of attached ligaments 2.
• While less common than scaphoid fractures, triquetral fractures should remain in the differential diagnosis for patients with ulnar-sided wrist pain after falling on an outstretched hand 2.

Comparison with Scaphoid Fracture

• Scaphoid fractures account for 90% of carpal fractures and occur predominantly in young men 3.
• The treatment approach for scaphoid fractures includes cast immobilization, and surgical fixation is considered for displaced fractures or non-unions 3, 4.
• In contrast, triquetral fractures are often treated with nonsurgical management, which usually results in good outcomes, and surgical treatment is indicated for fractures with significant displacement or evidence of instability 2.

Diagnosis and Treatment

• Diagnosis of triquetral fractures can be challenging, and special X-rays or imaging studies may be necessary to confirm the diagnosis 2, 5.
• Treatment of triquetral fractures depends on the type and severity of the fracture, and may include immobilization, surgical fixation, or other interventions 2, 5.
• It is essential to thoroughly evaluate patients with suspected triquetral fractures to determine the best course of treatment and prevent potential complications 2, 6.