Fractures of the hook of the hamate

Abstract

Fractures of the hook of the hamate are rare injuries. Six new cases are presented; the most usual mechanism is probably a direct blow to the area of the hook. The diagnosis, which can only be made by special roentgenographic techniques is usually missed at the acute phase. Most of the cases are diagnosed when painful non-union, fraying tendinitis of the flexor tendons to the ulnar fingers, ulnar or median nerve deficits appear. The adequate treatment is usually excision of the hook fragment.

Clinical classification and treatment strategy of hamate hook fracture

“…The fracture union rate could reach 87.5% [8] . But other authors found the non-union rate of conservative treatment was as high as 83.3%-100% [9][10][11] . One reason for the substantial difference lies in their failure to classify the cases in their analysis of results.…”

Avulsion Fracture of the Hamulus From Clay Gunshot Sport: A Case Report

“…[5][6][7][8] Walsh and Bishop 1 found that there has been an increase in the frequency of reported cases and small series of fractures of the hook of hamate and theorized that this is attributable to the growing popularity of golf, racket sports, and baseball. Our patient had hamulus nonunion and FDP tendon rupture after an episode of repetitive clay shotgun shooting.…”

Tendon rupture of the flexor digitorum profundus of the little finger secondary to hamate non-union

“…Stark et al found that 47 out of 62 patients had a base fracture [5]. Of the 27 cases of flexor tendon rupture due to non-union of the hook of the hamate, the exact fracture site was only reported in eight studies [7][8][9][10][11][12][13][14]. Contrary to the findings of Pajares-López et al [10], the hook of the hamate is fractured most often at its base [5].…”

“…Nevertheless, patients may not experience any pain because of the padding provided by the hypothenar area. Edema may be present in the acute phase of the injury [8]. Given that the hook of the hamate acts as a simple pulley for the FDP tendon of the little finger, distinct pain can be triggered upon flexion of the little finger across the hand, while placing the wrist in ulnar deviation.…”

“…The most common fracture mechanism is a direct impact to the hook itself [2][3][4][5]8]. This can occur after a patient falls and lands on the hypothenar side of the carpus or more typically, in those who participate in sports such as golf, squash, tennis or baseball.…”