Hamatometacarpal Fracture-Dislocations: Clinical Evaluation, Treatment Strategies, and Outcomes.

Objective: Hamatometacarpal fracture-dislocations (HMFD) are rare hand injuries resulting from axial loading. This study aimed to present the clinical presentation and outcomes of HMFD, which is rare and likely to be missed in the emergency department. Methods: A retrospective analysis of 15 patients who underwent surgical intervention for HMFD between 2015 and 2023 was conducted. At the last follow-up, the presence of union, malunion, residual subluxation, and Kellgren-Lawrence grading scale were evaluated. Time to diagnosis, time to return to work (RTW), level of difficulty in working, grip strength, and disabilities of the arm, shoulder, and hand (DASH) scores were evaluated. Results: The mean patient age was 30.6 years. Most injuries (93.3%) were due to punching. Open reduction was performed in 73.3% of cases. No complications were reported during the mean of 52.3-month follow-up. Open reduction was associated with a lower DASH scores. Hand-intensive work was correlated with a longer time to RTW and higher difficulty to RTW. Delayed diagnosis was correlated with worse grip strength, but not with significantly different DASH scores. Conclusion: HMFD is a rare hand injury that presents as a diagnostic challenge. Achieving anatomical reduction is crucial for restoring hand function. Therefore, comprehensive treatment strategies should be planned individually, taking into account patients's injury patterns. [ABSTRACT FROM AUTHOR]