Hamate fracture

Background

• Must exclude injury to ulnar nerve/artery (forms part of Guyon canal)
• May involve the body, hook, or articular surface
  • Hook:
    • Common
    • Assoc w/ interrupted swing w/ club, bat, or racquet (handle impacts hypothenar eminence)
  • Body:
    • Rare
    • Assoc w/ fx-dislocations of 4th/5th metacarpals

Clinical Features

• Localized tenderness over hamate (elicited by compresing hypothenar eminence)

Imaging

• Standard and carpal tunnel views should be obtained
• CT may be needed to identify occult fx

Management

• Hamate Hook Fx
  • Compression dresing or splint
  • Nonunion is common and excision of bone may be necessary
• Body Fx
  • Stable: splint immobilization
  • Unstable (displaced, Guyon canal injury): splint immobilization and ortho referral

Images

Source

• Tintinalli