Rehabilitation After ORIF of a Coronal Hamate Body Fracture With Dorsal Fifth Carpometacarpal Joint Dislocation: A Case Report
Nikolaos Gravvanis, Ioannis Kougioumtzis, Ronit Patel, Vasileios Psychogios, Dimitrios Skouteris, Andreas StamatisBACKGROUND: Coronal hamate body fractures with ulnar carpometacarpal (CMC) joint instability are uncommon and may be missed on radiographs; rehabilitation must balance fixation protection with stiffness prevention.
CASE PRESENTATION: A 46-year-old man sustained a left wrist/hand injury in a road traffic collision. CT confirmed a coronal hamate body fracture, dorsal fifth CMC joint dislocation, and fourth metacarpal base fracture. ORIF with dorsal plate fixation and temporary Kirschner wires was performed 6 days post-injury. Rehabilitation included orthosis protection, edema control, early finger ROM and tendon gliding, delayed wrist ROM until wire removal, and progressive strengthening.
OUTCOME AND FOLLOW-UP: At 10 weeks, QuickDASH was 23.3/100 with maintained alignment and mild stiffness; by 6 months, ROM and function were restored.
DISCUSSION: CT-based diagnosis and staged rehabilitation may protect fixation while limiting stiffness.