Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

Featured on Channel NewsAsia

Fracture of the Hook of the Hamate

The hook of the hamate bone projects anteriorly on the lateral side of the palm. A compression fracture of this bone is a rare injury, but it may occur in racket sports, baseball, ice hockey, and cycling if the handle of the racket, bat, club, stick or handlebar is compressed on to the hook of the hamate.

Symptoms and diagnosis

– Pain and tenderness are felt on the little finger side of the palm.
– The grip has little power.
– Numbness of the little finger is caused by irritation of the ulnar nerve.
– An X-ray with a carpal tunnel view, or a CT scan, is necessary to verify the diagnosis.

Treatment

The athlete should:
– rest and cool the injury;
– consult a doctor.

The doctor may:
– verify the diagnosis with X-ray or CT scan;
– recommend a period of rest to allow symptoms to decrease;
– operate and remove the hook in some displaced fractures or when nonunion remains symptomatic.

Healing and complications

– This fracture is easily overlooked.
– Healing of this fracture is rare even with internal fixation, but nonunions of hamate fractures are often not painful.
– Distal ulnar neuritis.
– Flexor tendon injury.

The athlete can usually return to sport as soon as symptoms allow.

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