Imaging of hamate bone fractures in conventional X-rays and high-resolution computed tomography - An in vitro study

RATIONALE AND OBJECTIVES. 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). MATERIALS AND METHODS. In an in vitro experiment using 18 cadaver hands, th e hamate bone was fractured at different places. Before and after fracture, conventional X-rays were taken in different planes (anteroposterior, later al, oblique, and carpal tunnel), and HR-CT was performed with 2-mm layer th ickness 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%, t he 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 selecte d.