Hook of hamate fracture

Hook of hamate fracture

Hook of hamate fracture is a fracture of a hook shaped protrusion on the hamate bone, which is one of the small carpal bones in the wrist. It may occur when swinging a golf club or tennis racket against an immovable object. Here we explain the symptoms, causes and treatment for a hook of hamate fracture.

Symptoms

Symptoms of a fracture of the hook of hamate usually follow a traumatic incident and include:

  • Wrist pain on the little finger (Ulna) side of the wrist.
  • You will have reduced grip strength.
  • You will also experience pain or tenderness when touching the palm side (volar) of the wrist, especially over the hook part of the hamate bone.

Imaging

Routine X-rays of the wrist is not likely to show a hamate hook fracture up. A CT scan or MRI is more likely to this type of wrist fracture.


Wrist pain zones - volar, palmer, ulnar, radial
Wrist pain zones

What is a Hook of hamate fracture?

It is a specific break of the hamate bone in the wrist. The hamate is one of the seven carpal bones. The bony protrusion on the hamate bone is called the ‘hook of hamate’. It is this part of the hamate bone which is commonly fractured.

Bones of the hand and wrist

What causes a hook of hamate fracture?

A hook of hamate fracture in the wrist can occur from swinging a golf club, tennis racket or baseball bat, particularly if it suddenly hits an immovable object.

For example if you swing a golf club hard and it strikes the floor instead of the ball. The sudden force going through your wrist may cause a break of the hamate bone.

Being struck from behind by a car when cycling may cause the handlebars to be forced upwards violently, therefore having a similar effect as the Golf club example.

Stress fractures

A stress fracture may also occur and is more common in Baseball. This is caused by repeated trauma over time and may even go unnoticed. If it does, then it could possibly turn into an acute fracture.


Treatment for a hook of hamate fracture

  • If you suspect a broken wrist then seek professional medical advice as soon as possible.
  • Initial treatment usually involves immobilization in a plaster cast for 4 weeks.
  • However, if your injury is noticed late, then it is likely if will fail to heal. If this happens, the most popular option is to surgically remove the hook fragment of bone completely. This is followed by immobilization in a paster cast for 3 weeks.

How long will it take to heal?

  • Return to sports specific training may take 6 weeks or more.
  • When the wrist comes out of the cast, mobility and strengthening exercises should be done to restore full movement.
  • Putty exercises and using hand exercise balls are excellent for achieving this.

Go to wrist strengthening exercises.


Further reading & references

  • Aldridge JM 3rd, Mallon WJ. – Hook of the hamate fractures in competitive golfers: results of treatment by excision of the fractured hook of the hamate. Orthopedics. 2003 Jul;26(7):717-9.
This article has been written with reference to the bibliography.
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