Fracture of hamate
The hamate bone is a bone that may be readily distinguished by its wedge-shaped form, and the hook-like process, which projects from its volar surface. It is situated at the at the medial and lower angle of the carpus, with its base downward, resting on the fourth and fifth metacarpal bones, and its apex directed upward and lateral ward.
What causes a fracture of hamate?
A fracture of the part of the hamate bone called the hook of the hamate is very common in golfers, weight lifters and after a fall on the hand.
Pain on the volar and ulnar aspect of the palm, exacerbated by pressure and gripping. Swelling and bruising are often present early. Because of the proximity of the ulnar nerve, numbness and tingling are often present in the ring and small fingers. Grip strength is decreased because of the pain.
How to diagnose it?
A comprehensive medical history and a precise physical examination are very suggestive. Confirmation of the diagnosis is obtained with X rays, MRI or a CT scan. Sometimes, a nerve conduction study is required to assess the nerve.
When the fracture is acute and undisplaced, cast immobilization for six weeks is usually successful, followed by hand therapy.
When the fracture is displaced or has failed to heal, surgery can be necessary and usually consists of removing the detached bony fragment. This is usually enough to alleviate symptoms and restore hand function.