Avascular Necrosis of the Hamate Treated with a 4–5 Extensor Compartmental Artery Graft: A Case Report and Literature Review
Bibliographic record
Abstract
Introduction: Avascular necrosis (AVN) of the hamate is an exceptionally rare condition, with limited cases reported in the literature. This case highlights the successful management of idiopathic hamate AVN using core decompression and a vascularized pedicle bone flap from the distal radius based on the 4-5 extensor compartmental artery (ECA). Case Report: A 45-year-old construction worker presented with chronic left wrist pain of 2 years' duration following minor trauma. Despite conservative treatment with cast immobilization, the symptoms persisted. Magnetic resonance imaging revealed AVN of the hamate, prompting surgical intervention involving core decompression and a 4-5 ECA vascularized bone flap supplemented with cancellous autograft. Post-operative follow-up demonstrated significant functional improvement, grip strength restoration, and successful revascularization confirmed by imaging. Conclusion: This report demonstrates the successful use of the 4-5 ECA-based vascularized bone flap technique in managing hamate AVN, as well as a literature review of 13 previously described cases.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".