Ding LH, Wu PF, Sun NZ. Investigation of clinical outcomes in conservative management of hook fractures: Commentary on recent findings. World J Orthop 2025; 16(5): 106881 [DOI: 10.5312/wjo.v16.i5.106881]
Corresponding Author of This Article
Nian-Zhe Sun, MD, PhD, Department of Orthopedics, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, Hunan Province, China. sunnzh201921@sina.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. May 18, 2025; 16(5): 106881 Published online May 18, 2025. doi: 10.5312/wjo.v16.i5.106881
Investigation of clinical outcomes in conservative management of hook fractures: Commentary on recent findings
Li-Hu Ding, Pan-Feng Wu, Nian-Zhe Sun
Li-Hu Ding, Pan-Feng Wu, Nian-Zhe Sun, Department of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Li-Hu Ding, Pan-Feng Wu, Nian-Zhe Sun, National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Co-corresponding authors: Pan-Feng Wu and Nian-Zhe Sun.
Author contributions: Ding LH wrote the first draft, developed the main ideas, and led revisions; Sun NZ and Wu PF provided critical feedback, improved the structure, and added key examples.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nian-Zhe Sun, MD, PhD, Department of Orthopedics, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, Hunan Province, China. sunnzh201921@sina.com
Received: March 10, 2025 Revised: April 8, 2025 Accepted: April 25, 2025 Published online: May 18, 2025 Processing time: 67 Days and 14.4 Hours
Abstract
This editorial critically evaluates the landmark study by Tanaka and Yoshii, which demonstrated a 100% union rate with conservative management of hamate hook fractures, challenging the historical preference for surgical intervention. In contrast to Scheufle et al’s report of 90%-100% failure rates with early surgical approaches, Tanaka and Yoshii’s protocol achieved universal healing despite delayed diagnoses in 25% of cases. Central to this success is the systematic integration of high-resolution computed tomography for early diagnosis and dynamic monitoring of trabecular bone regeneration, significantly reducing missed diagnoses and guiding personalized immobilization timelines. The patient-centered strategy—allowing temporary splint removal during low-risk activities—balanced fracture stability with joint mobility preservation, avoiding post-treatment stiffness. However, limitations such as small sample size (n = 16), selection bias, and insufficient long-term functional data (e.g., grip strength, return-to-sport metrics) underscore the need for comparative trials. Emerging trends, including adjunct therapies like low-intensity pulsed ultrasound and biologics (e.g., teriparatide), are proposed to accelerate healing while minimizing immobilization risks. This work redefines conservative fracture management paradigms, emphasizing innovation without compromising efficacy. Overall, this assessment deepens our understanding of the conservative management of hook fractures and provides evidence-based insights for improved clinical decision-making.
Core Tip: Although the conservative treatment of hook fracture has achieved good clinical efficacy, integrating advanced imaging, biologics, and physiotherapy to redefine conservative strategies, prioritizing precision and patient-centric care.
