Hook Of Hamate Fractures.

[PostalLefty]

Currently recovering from a hook of hamate fracture and have talked to a few people who have also had the injury both resulting in surgery. 
 

My doctor opted not to do surgery and curious if anyone else has had this injury and how they dealt with it 

 

It’s an injury usually happening around sports like Baseball, Golf, Tennis so figured maybe this is an issue someone else has had as well and may have something to share. 
 

TIA! 

[farmer]

Have seen posts about this injury, never had one.  IIRC, this is a serious injury that needs to be dealt with in a serious manner.  

[TiScape]

I’m only familiar with this injury from baseball. Typically caused by players putting the knob of the bat in their palm when they hit. In my experience surgery to remove the bone is typically the outcome. Back playing in about 6 weeks 

[Golferguy209]

56 minutes ago, TiScape said:

I’m only familiar with this injury from baseball. Typically caused by players putting the knob of the bat in their palm when they hit. In my experience surgery to remove the bone is typically the outcome. Back playing in about 6 weeks 

I was the athletic trainer for a college baseball team for 3 years and saw this case once. It was treated surgically. He was a power swinger and the knob of the bat was the culprit. His recovery took probably 3 months until he was cleared by the ortho hand surgeon. 
 

@PostalLefty maybe depending on the severity of the fracture is why your surgeon decided to go non-operatively.  It’s a tricky surgery because there is a nerve and artery that travel through the area of the hook of the hamate. Which is why the scar is surprisingly bigger than you’d expect. I did have to do a lot of scar tissue work with the baseball player to improve the range of motion of his fingers and wrist.

[PostalLefty]

12 hours ago, Golferguy209 said:

I was the athletic trainer for a college baseball team for 3 years and saw this case once. It was treated surgically. He was a power swinger and the knob of the bat was the culprit. His recovery took probably 3 months until he was cleared by the ortho hand surgeon. 
 

@PostalLefty maybe depending on the severity of the fracture is why your surgeon decided to go non-operatively.  It’s a tricky surgery because there is a nerve and artery that travel through the area of the hook of the hamate. Which is why the scar is surprisingly bigger than you’d expect. I did have to do a lot of scar tissue work with the baseball player to improve the range of motion of his fingers and wrist.

Thanks for the info and yes I had a buddy I grew up with who said basically holding on to the knob versus butting your pinky too it is what popped his and think my similar grip with my driver may be the culprit here.  Just the perfect amount of pressure at the perfect angle popped it I’m assuming with how much lighter a golf club is than a baseball bat 

[Golferguy209]

3 minutes ago, PostalLefty said:

Thanks for the info and yes I had a buddy I grew up with who said basically holding on to the knob versus butting your pinky too it is what popped his and think my similar grip with my driver may be the culprit here.  Just the perfect amount of pressure at the perfect angle popped it I’m assuming with how much lighter a golf club is than a baseball bat 

 

I think it is common in carpenters as well, same concept, rubbing against that area of the hand.  

 

 

[PostalLefty]

1 minute ago, Golferguy209 said:

 

I think it is common in carpenters as well, same concept, rubbing against that area of the hand.  

 

 

By the time I try to pick up a golf club again it’ll be 8 weeks.  I questioned the doctor and said once it heals the typical it’ll heal back stronger deal.

 

I’m going to change my grip and move back to the the dri tac wraps since they’ll be a touch easier on the hands than the MCC  I likely go through rough patch with all the change but so be it 
 

and I JUST put those MCC grips on my irons.  
 

🥲

[Golferguy209]

 

3 hours ago, PostalLefty said:

By the time I try to pick up a golf club again it’ll be 8 weeks.  I questioned the doctor and said once it heals the typical it’ll heal back stronger deal.

 

I’m going to change my grip and move back to the the dri tac wraps since they’ll be a touch easier on the hands than the MCC  I likely go through rough patch with all the change but so be it 
 

and I JUST put those MCC grips on my irons.  
 

🥲

I think you'll be okay to continue to use MCC.  I'd wait to change any grips until you were at least able to swing the club and hit the range.  You might be able to find a baseball hitting glove that has the padding over the hook of the hamate location.  I think batting gloves generally use a thinker leather too.

 

 

[sprayman]

Had fractured hamate from golf. Felt like I was shot when it snapped. Tried to play through it for about a month. BAD IDEA. Rough edge of fracture was eroding tendon and started to endanger nerve.

 

Get it fixed by an orthopod who specializes in hand surgery.

 

Was very easy recovery, like it never happened inside of a month

[TheDominator273]

Mine didn't fracture but I had lots of inflammation and pain stemming from that area and ended up with a cortisone shot.  Hasn't been an issue since (going on 8 years now)

[Ferguson]

History has shown that if you listen to enough people in the threads at WRX, you'll get the answer you want to hear with a zero copay.

 

Hope you feel better. 

 

[cwilk]

I had it and knew I had it based on Google results of symptoms.  First doctor couldn't find it with just an x-ray (as expected), and sent me to get a CT scan.  That facility apparently had a poor machine or tech and said it wasn't broken.  I got to wear a splint for several weeks with no improvement.

 

Then I went to an orthopedic specialist who didn't specialize in hands who sent me for an MRI.  The MRI came back saying no soft tissue damage, but that I DID have a fractured hamate.  That ortho put me in a cast for like 8+ weeks.  This was in direct contradiction to the standard of care for the injury.  Cast came off and it was still broken (no surprise to me).  There is just no way for the bone to reattach because it's basically floating in the hand.  And as two others have already mentioned here, that's potentially really bad for the soft tissue and nerves in the hand.  It's like having a piece of a saw in the hand moving around, cutting what it is in contact with.  

 

Finally, I found a hand specialist that had recently performed the surgery for one of the Houston Astros.  There was a news article I found online that led me to the doctor.  I saw him and had to do another CT scan.  He said the first was garbage and that with breaks there can be some concern using MRI's as it could pick up inflammation that appears like a break.  The new CT confirmed the break and I had surgery a few days later.  It took a few months to get back to golf, mostly because they have to cut through the entire palm so it's a long, deep cut that has to heal.  Once I was healed I had no other issue.  I lost no club head speed and have no lasting effects other than the scar, which isn't that obvious except when looking up close.

 

The guy I used was Thomas Mehlhoff, M.D.

 

https://texasorthopedic.com/physicians/profile/Dr-Thomas-L-Mehlhoff-MD

 

https://www.crawfishboxes.com/2016/3/15/11239206/astros-catcher-max-stassi-to-have-surgery-miss-six-weeks

 

https://www.chicagotribune.com/news/ct-xpm-2012-09-24-sns-rt-bbo-astros-team-reportsxeab4ba1-20120924-story.html

 

I think he specializes on injuries from the elbow down:

 

https://astros.mlblogs.com/bregman-undergoes-procedure-on-right-elbow-b551e6c40d01

 

 

Edited May 21, 2021 by cwilk

[PostalLefty]

3 hours ago, sprayman said:

Had fractured hamate from golf. Felt like I was shot when it snapped. Tried to play through it for about a month. BAD IDEA. Rough edge of fracture was eroding tendon and started to endanger nerve.

 

Get it fixed by an orthopod who specializes in hand surgery.

 

Was very easy recovery, like it never happened inside of a month

I was in a splint less than 3 hours after the swing that popped it LoL 
 

So hoping that the 8 weeks and it being caught early result in no surgery I’ll probably take another week or so after that even.  
 

Doctor said surgery is usually needed as a result from someone in your situation where it’s something people play through not knowing what exactly is going on. 

[phil75070]

Years ago I must have initially just fractured the hook-of-hamate bone. I thought I had just sprained my wrist (right hand and I'm a right-handed golfer). Played through it for a couple of weeks maybe until teeing off one day on the 1st hole. That is when I must have broken the top right off as it felt like I had gotten shot in the hand. Tried to hit my 2nd shot from the fairway and couldn't even grip the club.

 

Back in those days I needed a referral to see any kind of specialist and my PCP took x-rays, other tests, insisted it was carpal tunnel. I finally convinced him, after a moth or more, to let me go to an ortho.

 

My ortho at the time, a fellow golfer and one who specialized in sports injuries, had me hold my hand out and pressed on the area where that bone is located. I winced and pulled my hand back. He wasn't in the room 30 seconds when he diagnosed a broken hook-of-hamate. He took x-rays and even knowing what he was looking for it is very difficult to see. I think I went for some kind of scan to confirm it IIRC. He wouldn't do the surgery himself as I believe there may be two nerves that go around either side of it. He sent me to a hand specialist. My options were to have a pin inserted or have it removed. I opted for the removal.

 

I want to say it took a couple of months to just get back to pitching and chipping and several months for mild numbness to go away in my pinky and ring finger and be able to hit balls without pain or discomfort (from the club against the palm). I also had to constantly massage the area once out of the cast to breakup any scar tissue and/or keep it from forming.

[me05501]

I went through this. Tried to let it heal for a time but the hand specialist I finally saw said the bone won’t heal on its own, there isn’t enough blood flow to that area to feed the injury. Had the surgery, no big deal. Wish I had done it right away. 

[PostalLefty]

11 hours ago, me05501 said:

I went through this. Tried to let it heal for a time but the hand specialist I finally saw said the bone won’t heal on its own, there isn’t enough blood flow to that area to feed the injury. Had the surgery, no big deal. Wish I had done it right away. 

How long in between it happening and seeing the hand doctor? 

[me05501]

1 minute ago, PostalLefty said:

How long in between it happening and seeing the hand doctor? 

I can’t really recall, but first I saw a general ortho guy whose X-ray tech didn’t know how to get the right view. They ordered an MRI or something and could see the injury light up. They made me a light brace to wear and recommended taking calcium supplements for a good while to see if it healed (and also said avoid golf). None of that made any difference. 
 

When I went to a real hand doc, they were easily able to get a simple X-ray that showed the fracture and said there was no way it would heal on its own. Som surgery and quick recovery. 

[PostalLefty]

5 minutes ago, me05501 said:

I can’t really recall, but first I saw a general ortho guy whose X-ray tech didn’t know how to get the right view. They ordered an MRI or something and could see the injury light up. They made me a light brace to wear and recommended taking calcium supplements for a good while to see if it healed (and also said avoid golf). None of that made any difference. 
 

When I went to a real hand doc, they were easily able to get a simple X-ray that showed the fracture and said there was no way it would heal on its own. Som surgery and quick recovery. 

Okay so the pain continued after the brace?   It seems to be getting better and from the X-Rays that were took this week he said it’s healing (Idk what the hell I’m looking at so who knows)

 

like mentioned literally the second it happened I went straight to urgent care and the following week had it diagnosed as the Hamate fracture..... He is a hand specialist just obviously scary seeing surgery is what most end up doing because the healing on its own path doesn’t work.  Obviously any surgery is a risk but at this point if it just happens again and I wasted 8 weeks of recovery time. 

[PostalLefty]

Went to get cleared.

 

 

Bone didn’t heal correctly and will end up with surgery after all.... Guess it’s a 50/50 with the injury healing naturally and mine didn’t quite join back together it seems. 
 

 

[RyanMWilde]

Hi, I am 5 weeks post hook of hamate excision. This is following 5 years of rest, mid-diagnosis, wrist arthroscopy etc. so extremely frustrating when you enjoyed playing golf at least once a week. The surgery was a success and I know it is only 5 weeks but I can’t help think I still have a similar pain when pressing the 5th knuckle (pain in knuckle and ulnar side of wrist). Appreciate this may be linked to surgery/scar tissue but was wondering if anyone else had similar?

[mirzayac]

has anyone healed from this without surgery? I am currently 2 weeks in a splint after being diagnosed with a hamate fracture in the base of the hook. They tell me I should be pain free at 6 weeks and good to go, if not I will have to get the surgery.

 

My hook is still connected and there is a small fracture at the base, hope it heals up. Been putting heating pads on it to get bloodflow to the area, and been splitting religiously 

[me05501]

34 minutes ago, mirzayac said:

has anyone healed from this without surgery? I am currently 2 weeks in a splint after being diagnosed with a hamate fracture in the base of the hook. They tell me I should be pain free at 6 weeks and good to go, if not I will have to get the surgery.

 

My hook is still connected and there is a small fracture at the base, hope it heals up. Been putting heating pads on it to get bloodflow to the area, and been splitting religiously 

 

As posted above I tried to heal it for a year or longer without surgery but it turned out to be a waste of time and effort. 

 

If your original injury is due to golf then golf is likely to reoccur as soon as you go back to golf. If you have decent insurance it's preferable to have it surgically removed. 

[mirzayac]

do you remember where your break was? was it displaced?

[mirzayac]

3 minutes ago, me05501 said:

 

As posted above I tried to heal it for a year or longer without surgery but it turned out to be a waste of time and effort. 

 

If your original injury is due to golf then golf is likely to reoccur as soon as you go back to golf. If you have decent insurance it's preferable to have it surgically removed. 

do you remember where your break was? was it displaced?

[me05501]

7 minutes ago, mirzayac said:

do you remember where your break was? was it displaced?

 

It was cracked partially through. I could play golf but it wasn't without pain. 

[Golferguy209]

I agree on trying to move forward with surgery if you can. Otherwise, I would look into some red light laser therapy specifically with Novothor. Red light laser has been shown to speed fracture healing. The hook doesn’t have great blood flow so healing rate will be slow going.
 

https://www.novothor.com

[mirzayac]

On 6/26/2023 at 4:28 PM, Golferguy209 said:

I agree on trying to move forward with surgery if you can. Otherwise, I would look into some red light laser therapy specifically with Novothor. Red light laser has been shown to speed fracture healing. The hook doesn’t have great blood flow so healing rate will be slow going.
 

https://www.novothor.com

my fracture is non displaced and at the base, I am actually starting red laser therapy today and will try for a month then surgery after if not.

[CUTiger1981]

Having surgery to have the tip

of the hook of the hamate bone removed in my lead hand/wrist on Tuesday.  Will post some updates, do’s/don’ts, advice, etc.

 

Started doing The Stack speeding training system last winter and made a ton of progress but in the spring, was having some minor wrist pain so I stopped with The Stack as I had a few upcoming tournaments. 
 

All summer I’ve had some very minor wrist & ring/middle finger pain but only when I’m first warming up. After about 5 balls, no pain. 
 

Monday of last week after a two-day tournament, my wrist was really bothering me but I had a USGA MidAm qualifier on Thursday and another tournament Sat-Sun before going out of town for 2 weeks without my sticks, so figured it was tendinitis and I’d be good after 2 weeks of rest. 
 

Well….not the case. I hit a drive on the 3rd hole of the MidAm Q and felt something pop in my left hand. Tried to finish the hole but was essentially swinging one-handed, and had to WD.  Saw a hand specialist later that day who confirmed via X-ray (must use what’s called the “carpel tunnel view”) that I broke the hook of my hamate bone. 
 

Given the 40-50% nonunion rate of going the casting option, I opted for the surgery.  Doc told me he expects I’ll be able to do some light chipping/putting after 3 weeks and should be back to full swings by around 6 weeks but from what I’ve read, that might be an optimistic timeline. 

Edited August 27, 2023 by CUTiger1981

[Golferguy209]

On 6/28/2023 at 5:16 AM, mirzayac said:

my fracture is non displaced and at the base, I am actually starting red laser therapy today and will try for a month then surgery after if not.

Any update on how well you healed?

[HitSomeMissSome]

This injury should never happen. The end of the club shouldn’t be near the bone. Weaker/palmy grips lead to the end of the club putting tremendous force in this area. Not saying you can’t play good golf w this style of grip (see Bryson), but the hand is way safer when the hypothenar (heel pad) is on top of the handle, rather than beside the handle. This is independent of whether you have a weak grip or not.