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Image challenge
Carpal bone fracture not to be missed
  1. Gautam Reddy1,
  2. Niall Maher2,
  3. Ravindra Badge1,
  4. Nasir Shah1
  1. 1 Trauma & Orthopaedics, Warrington and Halton Hospitals NHS Foundation Trust, Warrington, UK
  2. 2 Trauma & Orthopaedics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  1. Correspondence to Gautam Reddy, Trauma & Orthopaedics, Warrington and Halton Hospitals NHS Foundation Trust, Warrington WA5 1QG, UK; gautamreddy20{at}yahoo.co.uk

https://doi.org/10.1136/emermed-2019-209005

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    Clinical introduction

    A young patient presented to the emergency department after a fight in which he sustained an injury to his right hand by punching. On clinical examination, there were no lacerations; there was noticeable swelling on the ulnar side of the dorsum of the wrist and he was very tender just distal to the ulnar styloid process. The hand was neurovascularly intact with no rotation deformity of the fingers. The patient had plain radiographs (figures 1 and 2).

    Figure 1

    Postero Anterior (PA) view hand.

    Figure 2

    Lateral view hand.

    Question

    What is your diagnosis?

    1. Fifth metacarpal neck fracture.

    2. Coronal split fracture of the body of the hamate.

    3. Capitate fracture.

    4. Hook of hamate fracture.

    Answer: B

    The coronal split fracture of the body of the hamate is relatively rare and …

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    Footnotes

    • Contributors GR has written the provisional manuscript. NM, RB and NS performed proof reding and edited the manuscript. They also edited the images.

    • 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.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

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