Hamate Fracture

The hamate bone is a wedge shaped bone found below the little finger and near to the wrist. It protrudes in a 'hook' formation. Injuries to this bone are relatively rare but nevertheless have increased in prominence as participation soars in sports that use bats and racquets.

Symptoms

Aching or sharper pain around the area of the hamate bone, which may be worsened with wrist or hand movements, especially strenuous motions involved in most bat and racquet sports. Moving the ring finger and the little finger often proves particularly painful due to their proximity to and connection with the hamate bone (via the metatarsals). Grasping or clutching any bat or other instrument might also intensity the pain sensation. In some cases symptoms can be minimal, thus the injury can go untreated for a long time.

Causes of Hamate Fractures

Sports involving clubs, bats or racquets provide the most consistent cause of hamate fractures due to the way in which they encourage the hand to turn and twist at speed. It is thought that the most common of these causal injuries is arises as a result of repeated golfing swings (or hitting the ground during a swing), accounting for approximately one third of all hamate injuries. Repetitive motions like this in any such sport (e.g. tennis or hockey) can result in a stress fracture over time.

Another prominent cause is blunt trauma to the hamate bone, resulting from direct force to the area either from another participant, or from the base of a club, bat or racquet that is held on the hamate at the forceful moment of the swing. Falling injuries can indirectly cause a hamate fracture through the surrounding muscles or ligaments, especially when hyperextending the wrist by landing flat on the palm. Some other wrist complaints can also lead to the condition.

Complications of a Hamate Fracture

The ulnar nerve frequently becomes compressed as a result of hamate fractures. This is due to the location of the hamate at the Guyon canal, close to the motor section of the ulnar artery and nerve. Another possible complication is injury to the flexor tendons of the ring and small fingers, interfering with successful flexing because jagged edges of the fracture have ruptured them.

Medical Treatment for Hamate Fractures

It is important to refrain from all stressful physical activities using the hand. Your doctor will examine the injury in order to determine that it is indeed a hamate fracture and the severity of the fracture. Medical treatment varies greatly depending on the individual injury and the recommendations of a specific doctor. Many hamate injuries in the past have been treated through a program of immobilisation for 6 to 8 weeks, implementing a cast to avoid damaging movements and allowing union of the bone. This may not always be suitable because of blood supply deficiencies, a late diagnosis, or the fact that ring and little fingers can still move inside the cast and may therefore worsen the injury despite immobilisation.

The preferred method is often for a professional hand surgeon to consider a suitable operation. The most common of the available surgeries involves excision of the hamate hook itself, while another procedure attempts internal fixation of the bone.