What is a Hook of Hamate Fracture?

The Hamate bone is one of the small eight carpal bones located in your wrist. The hamate specifically is located on the ulnar side of the wrist, opposite the thumb. The hamate bone is sometimes described as triangular in shape and others describe it as more square-like. It is an unusually shaped bone with the defining characteristic of a hook which is a process that projects from the palm side of the hand toward the outside of the body. This hook is important in that it provides the attachment site for many ligaments, tendons, and part of the flexor retinaculum that protect the carpal tunnel. Fracture to that Hamate is a rare occurrence but can have significant consequences because of the many structures that attach to it. Associated injuries with a Hook of the Hamate fracture are often injuries to the Ulnar nerve and Ulnar artery. It is commonly misdiagnosed as a wrist sprain, without further diagnostic techniques being ordered to determine if the bone has been broken.

What Causes a Hamate Fracture?

Causes of a Hamate fracture usually involve a high-impact, sports-related injury. If a child who is active in sports is complaining of chronic wrist pain, a Hamate fracture should be suspected. Some specific incidence that can cause a hamate Fracture are:

● Playing hockey, if the stick hits the ground instead of the puck which may drive the stick into the palm, breaking the Hamate bone
● Commonly also seen is golfers, baseball players, and tennis players
● These sports injuries are highly associated with blunt traumas, repetitive microtrauma, and avulsion injuries, which means that a piece of bone is torn off along with a ligament or tendon being torn from the bone
● Falls and crush injuries to the wrist are also causes of this condition
● Other traumatic factor resulting from car or motorcycle accidents may also be a cause

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What are the Symptoms of a Hamate Fracture?

Symptoms of a hook of the hamate fracture may include:

● Sudden onset pain and swelling
● A sensation of “pins and needles” radiating up into the ring and pinky fingers if the has been nerve involvement in the injury
● Loss of range of motion/stiffness
● Muscle spasms
● Weakness of grip

If You Are Experiencing Symptoms, Schedule an Appointment Dr. Burke Orthopedics Immediately.

Treatment for a Hook of Hamate Fracture

An x-ray is needed in order to accurately diagnose a fracture of the Hook of the hamate. A certain type of x-ray called the carpal tunnel view, is able to visualize the hamate and make a more accurate diagnosis. An MRI or CT scan may be ordered as well as they can show with more sensitivity if a Hook of the Hamate fracture has occurred. Once an official, accurate diagnosis has been made, there are several treatment options to choose from. These are:

Casting and immobilizing the area
For an athlete who wants to return to their sport as soon as possible, surgery may be indicated in order to remove the broken hook of the hamate. This is a very safe procedure when performed by a skilled surgeon and should have you back to your sport in 6 to 8 weeks’ time after a course of physical therapy to restore strength, range of motion, and function
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