The hamate is a small bone in the hand, just above the wrist. Hook of hamate fractures are uncommon, and doctors often miss them, leaving them undiagnosed.

The hamate is a wedge-shaped bone with a hook-like projection on the surface facing the palm. Healthcare professionals call this protrusion the hook of the hamate. It serves as an attachment point for muscles and tendons.

If a person experiences a trauma or injury to this bone, they may sustain a hook of hamate fracture. While these fractures are rare, direct trauma or force can cause them. Repetitive activities that put pressure on the hook of hamate can also cause fractures.

Read on to learn about the hook of hamate fracture symptoms, causes, diagnosis, treatment options, and more.

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Symptoms may be vague and unspecific, but wrist pain is common. A person may also have acute pain over the hypothenar area, which is at the base of the palm on the same side as the pinky finger.

Weakened grip strength is a common finding. If a person tries to grip an object, they often have pain along the wrist’s ulnar (outer) side. Flexing the ring and pinky finger may also cause pain.

Other symptoms may include:

A hook of hamate fracture usually occurs in sports where a person must use a firm grip. Some examples include hockey, tennis, baseball, and golf.

Repeatedly gripping a bat or club places pressure on the hook of hamate. Over time, this can cause a break.

Direct trauma, such as being hit on the hand or wrist with a hard object, is another cause of hook of hamate fractures.

Doctors use a person’s medical history and a physical examination to diagnose hook of hamate fractures.

During the physical evaluation, they may use the pull test. This involves active flexion of the ring and pinky finger to see if it causes pain.

For some people, doctors may order imaging tests to confirm the diagnosis. Initial X-rays include bottom and side views of the wrist.

Doctors may also use MRI scans to diagnose hook of hamate fractures. An MRI scan can give a more detailed picture of the bones, which can help a doctor see a small fracture. It can also visualize soft tissue structures, such as muscles, tendons, and ligaments.

Untreated hook of hamate fractures can cause long-term complications, for instance, chronic pain and instability in the wrist joint. These issues may limit movement, reduce grip strength, and affect a person’s ability to perform everyday tasks.

Other complications may include:

Treatment for a hook of hamate fracture depends on the severity of the injury.

Doctors may treat minor, non-displaced fractures with immobilization. This involves wearing an ulnar gutter cast for 6 weeks.

If the fracture is displaced, which means the bones have shifted, the person will need surgery. A surgeon can either remove small bone fragments or reposition the fractured bone and secure it with screws and wires.

People who play sports usually benefit from early surgical management because it allows them to return to play more quickly. Additionally, surgeons may recommend pinning with bone grafting for people with chronic pain and non-healing fractures.

Simple hook of hamate fractures typically heal in 6–8 weeks. After this, a person may need several weeks to months to regain full strength and range of motion.

Individuals who have surgery may need 3 months or more before returning to their sport. Depending on the intensity of the activity, it may take up to 6 months to return to their pre-injury activity level.

During recovery, a physical therapist can help with stretching and strengthening exercises designed to improve mobility, range of motion, and strength.

It is important to seek medical attention if a person experiences sudden pain, numbness, or swelling in the hand or wrist. A doctor can determine the cause of the symptoms and provide appropriate treatment.

Early diagnosis and treatment are important to prevent long-term complications that affect a person’s ability to perform daily tasks. Likewise, if a person has received treatment for hook of hamate fractures and experiences persistent pain or instability in the wrist joint, they should speak with a doctor.

The hook of hamate is a protrusion of the hamate bone in the wrist. People who play sports, such as tennis or golf, are at a higher risk of these fractures.

These injuries can cause pain, numbness, and swelling in the hand or wrist. Diagnosis typically involves a physical examination and imaging tests, such as X-rays and MRI scans. Treatment usually consists of immobilization and rest. In some cases, a person may need surgery.