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Hook of the hamate fractures in athletes

Department of Orthopaedic Surgery, Mt. Sinai Medical Center

Mark S. Berkowitz, MD

Lutheran Medical Center, Cleveland, Ohio

Malcolm A. Brahms, MD

Department of Orthopaedic Surgery, Mt. Sinai Medical Center, Department of Orthopaedic Surgery, Mt. Sinai Medical Center

William R. Bohl, MD

Lutheran Medical Center, Cleveland, Ohio

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 play ers 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.

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