Hook of the hamate fractures in athletes

Abstract

Five patients have been treated for six hook of the hamate fractures over the past 8 years by the authors. Of these, four patients were professional baseball players and one patient was an accountant. All fractures occurred while playing baseball; four while swinging a bat, and two secondary to a fall on an outstretched hand. Roentgenographic diagnosis was made by carpal tunnel view alone in two, oblique and carpal tunnel view in one, bone scan and subsequent carpal tunnel view in two, and computerized tomography in one fracture. Five of the fractures were through the base of the hook, while one was toward the tip. All patients ultimately underwent hook resection, four early and two late. The patient who sustained the tip of the hook fracture underwent resection of the fracture only to refracture the same hook at its base 6 months later. All patients returned to their previous level of activity in 6 to 8 weeks after surgery without loss of function. Hence, it is the authors' opinion that the entire hook should be resected to the base of the hamate as the primary form of treatment in hook of the hamate fractures.

Fractures of the hook of the hamate in athletes: 8 cases followed for 6 years

“…Some authors (Watson and Rogers 1989) have recommended bone grafting for the treatment of the nonunion. However, we believe as other authors (Carter et al 1977, Stark et al 1977, Parker et al 1986, Smith et al 1988) that the entire hook should be resected at the base of the hamate as primary treatment.…”

“…Fracture at the base of the hook of the hamate may not be quite as rare as previously assumed (Carter et al 1977, Stark et al 1977, Parker et al 1986, Smith et al 1988. The diagnosis may often be delayed because the signs and symptoms are rather non-specific, and routine radiography is not always diagnostic ( Norman et al 1985, Polivy et al 1985.…”

“…Fractures through the hook of the hamate have been previously thought to be uncommon (Andress and Pecker 1970). Recently, however, this injury appears more common with the increasing popularity of golf, baseball, tennis and other racquet sports (Stark et al 1977, Parker et al 1986, Smith et al 1988. We describe our clinical experience and results of surgical treatment.…”

Return to Play After Hand and Wrist Fractures

“…Halim & Weiss expected about 6 to 8 weeks after injury. 15,16 The palmar incision is sensitive for 4 to 6 weeks, and may benefit from desensitization before return to sport. 4 Athletes at the collegiate level can expect to have no change in sports performance compared with their baseline, and typically are satisfied with outcomes.…”

Ulnar Neuropathy in the Distal Ulnar Tunnel

“…The patient, now less focused on the elbow, reported that her ring and little fingers 'felt cold at times." Examination of the right hand revealed an abnormal resting finger position that consisted of clawing of the fourth and fifth fingers (6). Atrophy of the intrinsic hand muscles innervated by the ulnar nerve was noted.…”