The Journal of Bone and Joint Surgery, Vol 59, Issue 5 575-582, Copyright © 1977 by Journal of Bone and Joint Surgery, Inc
Fracture of the hook of the hamate in athletes
HH Stark, FW Jobe, JH Boyes and CR Ashworth
During an eight-year period, four tennis players, seven golfers, and nine
baseball players were seen with a fracture of the hook of the hamate.
Eighteen of these twenty patients were disabled by pain and after the
fracture fragment was removed, all eighteen were relieved so that they
returned to their athletic pursuits. Two patients were asymptomatic, their
old fracture being discovered accidentally when they were treated for other
injuries. Nineteen of the twenty patients had been examined before coming
under our care, but the correct diagnosis had been made in only two.
Conservative treatment, including rest, physical therapy, and injections of
steroids into the wrist and hand, had not been beneficial. From the history
and findings, we believe that these fractures were caused by a direct blow
against the hook of the hamate caused by the handle of the tennis racket,
golf club, or bat during a swing, and not by indirect force produced by the
ligaments and muscles attached to the hook. The fracture was demonstrated
in all twenty patients by a roentgenogram (profile view) of the carpal
tunnel.
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