A 34-year-old male presented with a two-week history of pain with paresthesia in the ulnar edge of his hand and right fourth and fifth fingers after a tennis championship.
He had diffuse swelling in the volar face of the ulnar area of the wrist and hand, with Tinnel positive on the pisiform.
Radiology and ultrasound were normal.
After fixation of a corticoid with local anesthetic, the patient was immobilized with a wrist in a neutral position.
The neurophysiological study showed a compressive neuropathy of the ulnar nerve in the Guyon channel.
The patient was treated symptomatically with cryotherapy, orthoses, complex morphine analgesics B and physiotherapy.
In the Computerized Axial Tomography (CAT) of the wrist, requested due to persistence of pain at nine months, showed a pseudoarthrosis of the unciform apophysis of the hamate fragment.
He underwent palm approach, dissection of cubital neurovascular bundle, crossed pseudoarthrosis bed and osteosynthesis with two 1.5mm diameter Compact® titanium screws and Compact Hand (twoS).
1.
Mandate a forearm splint, including fingers, for three weeks, to which physiotherapy began.
Four months after surgery, the patient was free of symptoms, except hypoesthesia of the fourth finger, with complete mobility, recovered strength and return to work (force) and sports activities.
CT scan at two months and X-ray at three months showed partial fusion.
A new CT scan at four months showed complete binding.
