創傷性鉤狀骨和豆狀骨同時脫位：病例報告及文獻回顧

Simultaneous Traumatic Dislocation of Hamate and Pisiform: A Case Report and Review of Literature

單獨的鉤狀骨或豆狀骨脫位並不常見，兩者同時脫位更是罕見。57歲男性，工作時被重型瓦斯桶壓傷，導致左手鉤狀骨、豆狀骨、第4和第5掌骨同時脫位。我們推測其機制是由不同方向的力量壓迫，致使鉤狀骨和豆狀骨從韌帶固定處擠出。經由徒手復位及經皮克氏針固定，無需額外修補韌帶，在一年的追蹤評估後，患者已回到原來的工作崗位。新版的梅奧手腕評分為75分(滿意)。

Isolated dislocation of hamate or pisiform is uncommon. The simultaneous dislocation of both hamate and pisiform is even rare. A 57-year-old male suffered from simultaneous dislocation of left hand hamate, pisiform, the 4th and the 5th metacarpal bone due to crushing injury by a heavy gas cylinder. The speculated mechanism is a combination of force from different direction, which extruded the hamate and pisiform from their ligamentous fixation. The patient was treated with close reduction and percutaneous Kirschner wire fixation without any ligament repair. After one year, he has returned to his original heavy work with a satisfactory 75 points of modified Mayo wrist score.