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First reported case of a coronal hamate fracture associated with intrusion of the fifth metacarpal base, together with a fracture of the fourth metacarpal base
  1. Valerio Pace1,2,
  2. Giacomo Placella3,
  3. Giuseppe Rinonapoli4 and
  4. Auro Caraffa4
  1. 1T&O, The Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
  2. 2T&O, AOSP Terni, "Santa Maria della Misericordia" Hospital, Perugia, Italy
  3. 3"IRCCS Ospedale San Raffaele" Hospital, Milan, Italy
  4. 4T&O, University of Perugia, Perugia, Italy
  1. Correspondence to Dr Giacomo Placella; placella.giacomo{at}


We present a case reporting a rare combination of base of fourth metacarpal fracture and coronal body of hamate fracture, treated conservatively with excellent results. High index of suspicion for undetected bony injuries drove the execution of a CT scan, which allowed us to make a full correct diagnosis and plan treatment. Moreover, this case becomes the first reported case in the literature of such injury causing the intrusion of the base of the fifth metacarpal within the hamate bone, thus causing the coronal pattern of the hamate fracture. Differently from the common surgical management of this type of injury, we successfully treated this patient with close reduction and immobilisation, with full recovery after 3 months.

  • orthopaedic and trauma surgery
  • orthopaedics

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  • Contributors VP designed and performed the therapeutical procedure; GP and GR cowrote the paper; AC supervised the research.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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