UMEM Educational Pearls

Category: Airway Management

Title: Hook of hamate fracture

Keywords: had, wrist, carpal (PubMed Search)

Posted: 1/26/2019 by Brian Corwell, MD (Updated: 4/25/2024)
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Hook of hamate fracture

Often missed fracture despite classic history

A frequent athletic injury

Seen in stick sports (golf, baseball, hockey)

Typically caused by a direct blow (grounding a gold club)

Patient presents with hypothenar pain and pain with tight gripping

Presentation may be subacute with longstanding wrist or palmer pain

Physical exam: Tender to palpation over hook of hamate

Specialized test: hook of hamate pull test

Supinated hand held in ulnar deviation. Ask patient to actively flex 4^th and 5^th digits against resistance at DIP.

Radiology: Consider adding carpal tunnel view to standard wrist series if diagnosis is suspected

CT sometimes needed to image the fracture

Tx: Immobilize in a short arm splint

https://eorthopod.com/news/new-test-for-sports-injury-of-the-hand/

https://www.orthobullets.com/hand/6035/hook-of-hamate-fracture