TITLE: A case report on’ HOOK OF HAMATE EXCISION AND GUYONS CANAL RELEASE ‘ for ‘ULNAR

TUNNEL SYNDROME ‘ in ‘HOOK OF HAMATE FRACTURE’. AIMS AND OBJECTIVE: To evaluate

functional outcome of surgical management of ulnar tunnel syndrome in hook of hamate fracture.
METHODOLOGY: A 22 year old male came with a history of blunt trauma to the right hand and
sustained injury to the palmar aspect of the right hand and complaints of inability to completely
extend the right little and ring finger and decreased sensation over the distribution of ulnar nerve.
The carpel tunnel view radiograph showed hook of hamate fracture and MRI report saying fracture
of hook of hamate with contusions of the soft tissue within guyons canal. The surgical management
was done with excision of hook of hamate and release of Guyons canal for decompression of the
ulnar nerve. RESULTS: The functions of the right little and ring fingers became normal in 4 weeks and
he returned to his day to day activities in 6 weeks .the functions of intrinsic muscles of the hand
gradually improved with time

CONCLUSION : In ULNAR TUNNEL SYNDROME due to HOOK OF HAMATE fracture conservative

management is proposed when the symptoms are mild to moderate in severity and with acute to
subacute duration lasting upto 3 months. For moderate to severe symptoms surgical decompression
is favoured . The outcome of surgical release has better outcome with minimum complications.
Treatment includes post surgical physiotherapy and excercises in those with reduced range of
movements.