The hamate body is the large main portion of the hamate carpal bone, distinct from the hook of hamate (hamulus) that projects from its palmar surface. The body articulates with the lunate (proximomedially), the triquetrum (proximal), the fourth and fifth metacarpal bases (distally), and the capitate (radially). The body of the hamate contains the 4th-5th carpometacarpal joints and is the distal ulnar boundary of the wrist.
Hamate body fractures are distinct from hook fractures: body fractures occur in coronal plane from axial loading through the 4th-5th metacarpals (associated with 4th-5th CMC fracture-dislocation) and are often missed on plain radiographs but identified on CT. Hook fractures occur from repetitive grip impact (golf, baseball, racquet sports) or a single fall on the hypothenar eminence. Hamatotriquetral ligament injuries from ulnar-sided wrist trauma produce the midcarpal clunk in some patients.
Axial force through a clenched fist fractures the hamate body in the coronal plane and dislocates the 4th and 5th metacarpal bases dorsally; CT identifies the fracture pattern and CMC dislocation extent; ORIF with lag screw fixation of the hamate body restores the articular surface of the 4th-5th CMC joints.
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