Hook Of Hamate Fractures.

[cwilk]

On 9/7/2023 at 9:40 AM, HitSomeMissSome said:

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. 

The bone is in the pad of the hand. So when you grip the club correctly the shaft is parallel to the hook and applies shearing force against it. That is what causes the break. Not a shaft sitting on top of the hook. It’s most common with people with high swing speeds and/or those who hit on mats frequently. I swing a 6 iron around 101 mph and was hitting 300+ balls a day on rubber mats that sat on top of concrete at my home club around the time mine broke. 

Edited September 8, 2023 by cwilk

[Utah24]

I am 7 weeks post surgery -  Nondisplaced fracture at the base of the hook of the hamate with diffuse marrow edema.  The injury happened 7 months prior, and just like many of you before me, x-rays were negative, waited 3 months, tried to play, still had pain, finally had MRI that showed the fracture.

My hand was feeling pretty good and started to swing the club with no pain.  It's been 7 months without golf, and killing me.  Excited to get out there, I hit a bucket at the range with minor weakness in hand but no pain.  Few days later, after playing 18, my hand hurts pretty bad.  I'm concerned that I pushed it too fast.  Anybody else have this experience?  

[me05501]

Turns out my left hamate is fractured right through as revealed by MRI. I'm going into surgery tomorrow to have a screw inserted to hold the two halves together. 4-6 week expected recovery. 

 

 

[Golferguy209]

On 11/13/2023 at 3:58 AM, Utah24 said:

I am 7 weeks post surgery -  Nondisplaced fracture at the base of the hook of the hamate with diffuse marrow edema.  The injury happened 7 months prior, and just like many of you before me, x-rays were negative, waited 3 months, tried to play, still had pain, finally had MRI that showed the fracture.

My hand was feeling pretty good and started to swing the club with no pain.  It's been 7 months without golf, and killing me.  Excited to get out there, I hit a bucket at the range with minor weakness in hand but no pain.  Few days later, after playing 18, my hand hurts pretty bad.  I'm concerned that I pushed it too fast.  Anybody else have this experience?  

I’d say recovery can take up to 3-6 months. I worked with a baseball player who had this injury and it took him that amount of time to swing a bat at his full capacity. I’d say make sure you’re minimalizing the scar tissue build up in the incisions, maintaining wrist and finger ROM, then gradually working on strength and endurance. 

[norcaltrojan]

On 5/22/2021 at 11:51 AM, phil75070 said:

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 recently had the same experience and highly recommend seeing a sports specialist. I originally went to my PCP, who thought it was a tendon issue and recommended 6 weeks of rest. The next day, I went to see the specialist, who performed the same hand test and ordered an MRI to confirm. Well, he was right, and I'm having the hook removed next week. 

 

One thing that may help others in the same situation is that while the pain became manageable and I regained most function, full recovery plateaued, and it still presents a sharp pain if it's tweaked some four weeks after the injury. When I had tendon issues in my other wrist I could feel improvement week to week whereas this just seems stuck. 

[me05501]

On 11/29/2023 at 2:48 PM, me05501 said:

Turns out my left hamate is fractured right through as revealed by MRI. I'm going into surgery tomorrow to have a screw inserted to hold the two halves together. 4-6 week expected recovery. 

 

 

My surgery was 11/30/23 and I’m still not entirely healed. Taking Vitamin D and Calcium supps while trying to make sure I’m ready for my annual golf trip the first weekend of May. 
 

The last couple months I’ve been able to putt and chip. I recently added a small bucket to this routine but only once a week and mostly short irons. 
 

Tomorrow I’m going to attempt my first real round of golf this season. I will definitely be taking it easy and trying not to set my progress back by doing anything silly. 
 

My doctor said if I get six months out and the bone hasn’t fully healed we can talk about extracting it. All things considered I wish he had just extracted it to begin with. This fracture is through the main part of the hamate and not the hook so it was a judgment call. 
 

 

[norcaltrojan]

I went ahead and had extraction surgery last Monday. Overall, the procedure was pretty quick, ~45min but required general anesthesia, so the total time at the hospital was ~4 hours. The pain wasn't too bad and was managed with Oxycodone 5mg for three days, then transitioned to Tylenol, and now nothing at all. I was in bed the day of the surgery and then for half the following day but was partially back to work (I work from home in tech) the second afternoon. Operating a computer was tough since the surgery was on my dominant hand, but I was able to make it work. Five days after surgery, I had my cast/bandages removed and replaced with a custom plastic shell that's removable, and this Thursday (10 days after the operation), I get my stitches removed and start PT. Overall, I'm feeling positive with the original 4-6w recovery, but we will see and I'll try and keep everyone updated.

 

If you are in the Kansas City area and have this issue I'd be happy to refer you to the hand specialist I've seen because him + his team have been incredible

[norcaltrojan]

Final Update - At my 10-day post-op follow-up with the surgeon where I had the stitches removed, I finally asked if I would be able to go on a planned golf trip to Streamsong, which was five weeks from the date of surgery. He responded, "The scar looks good, so you can't hurt it, but it's going to feel uncomfortable. Go for it". Well, nothing will motivate rehab like a golf trip planned 8 months ago haha.

 

Recovery came in stages, but at the 2-3 week mark, I felt confident I could push it. The most uncomfortable part was the "mound" of scar tissue on both sides of the incision. After going to PT and getting homework exercises, it was recommended I do a heating pad and then scar massage 4x/day, which knocked it down over ~10 days. To rebuild strength, I walked at the gym doing the pt exercises, then added a 3lb weight and built to a "Synergee 5lb Indian Club" that they had at the gym. The "club" which looks like a juggling pin, not only helped with strength but also allowed me to practice gripping a club and work on the stages of a swing. At the four-week mark, I hit chips at the driving range and progressed to hitting full shots and then driver over the subsequent days. I was rusty, but even when I thinned or chunked a ball, my hand felt okay.

 

Five weeks from the day of surgery, I teed off at Streamsong Black, and while I didn't play well, I couldn't have been happier to be out there. We played Black / Red + Chain / Blue, and I got more comfortable each day. Two things that I think helped were 1)  a compression sleeve that covered my wrist and ended at the base of the fingers and 2) a Theragun massager. The compression sleeve covering the scar provided some reassurance and helped with the swelling. The Theragun was great for working the scar each night and also everywhere else on the body that ached. While the hand never felt like it was at risk, by the third day, all the other muscles in my hand were aching and weak, so after the trip, I took a few days off to let those recover. I've since played two more rounds and am confident I'll be back to my normal self in no time.

 

I'm incredibly grateful to the sports hand doctor and his team, who diagnosed and operated in just two weeks, which likely saved my golf season and summer. If anyone has any questions - feel free to DM me

[Atxdivebezel]

I’ve really appreciated this thread over the last several weeks. Going without golf as a result of this injury has nearly sank me into depression.  Wanted to add my own story, which is ongoing. 

 

I fractured my hook of hamate while swinging a  3W into a par 5 on my home course, felt like I’d been shot in the hand when it happened. Got to the green attempted to pull wedge and putter and simply couldn’t - went straight from the course to an imaging center for X-rays. I called my dr from the parking lot to get the order. After a brief search I knew those X-rays would be negative but I almost certainly had this injury which I’d never heard of but came up on forums when I searched the symptoms.
 

I was in front of the Ortho within 48 hours (May 8th) after going through the process of regular X-rays not showing anything but insisting on a referral from my PCP. Ortho diagnosed fractured hook of hamate within minutes.
 

As it wasn’t displaced Ortho pushed me into a cast saying surgery was needed less than 5% of the time in his experience with non-displaced fractures. The cast was the conservative route and should be taken as I don’t “play for a living”. I did explain to him that I do play to live so that should be taken into consideration. As I understand it the surgery is not without risk as an artery runs over the bone. I ended up sucking it up and leaving with the cast.
 

The cast came off five weeks later and that’s when he broke the news to me that I couldn’t swing a club until he saw me again July 29th. I was pretty pissed and let him know I would have elected for surgery without a second thought if I’d known recovery was such a drawn out process. The pain in my hand when the cast came off was bad - not where the bone is but in the fingers and wrist. I chalk up to lack of use but I also think the nerves have some damage or discomfort form on-going swelling. I couldn’t grip the steering wheel, lift any thing,  open a door, nothing.
 

Over the past couple weeks the hand has improved greatly but is still very “stiff” in the morning. By the afternoon I can make a fist and have full range of motion but those first few hours of the day are not great. 
 

It’s taken every ounce of will power to keep a club out of my hand. Im going to follow doctors orders but for everyone in my position who plays to live; get the surgery and save yourself this insufferable timeline. 

[me05501]

On 4/11/2024 at 5:31 PM, me05501 said:

My surgery was 11/30/23 and I’m still not entirely healed. Taking Vitamin D and Calcium supps while trying to make sure I’m ready for my annual golf trip the first weekend of May. 
 

The last couple months I’ve been able to putt and chip. I recently added a small bucket to this routine but only once a week and mostly short irons. 
 

Tomorrow I’m going to attempt my first real round of golf this season. I will definitely be taking it easy and trying not to set my progress back by doing anything silly. 
 

My doctor said if I get six months out and the bone hasn’t fully healed we can talk about extracting it. All things considered I wish he had just extracted it to begin with. This fracture is through the main part of the hamate and not the hook so it was a judgment call. 
 

 

 

 

So today is what, July 1? I had surgery 11/30 and the bone is still not joined. I can't do a push up and it's easy to "activate" the pain by moving my hand into different orientations. 

 

My golf hasn't really been affected and doesn't seem to make my hand any worse (unless that's the reason the bone hasn't healed). In fact my hand feels more sore if I go 3-4 days without swinging a club. 

 

Since my pain is manageable I'm probably going to wait until it's winter again to request an excision. I have another golf weekend planned for late September and I don't want to put that at risk by asking for another surgery now. 

[Golferguy209]

As a former athletic trainer, I worked with a few athletes that had hook of hamate fractures.  One treatment method that I'd recommend if choosing conservative route to promote healing is using red light therapy, specifically a company called Novothor had incredible research findings on the success of treatment for bone therapy.  One story that was shared at a training was during the filming of one of the many Mission Impossible movies, Tom Cruz broke his leg during filming and brought in a NovoThor redlight bed.  I guess he healed in record time.

 

https://www.novothor.com/us/

[me05501]

A year ago I had surgery to repair a clean fracture in the base of my left hamate. The doc put a screw in the bone and expected that it would probably heal but it hasn't. 

 

Met with him again yesterday and scheduled a second surgery to remove the bone completely. This time recovery should be easy because we'll just be waiting on the incisions to heal. 

 

I've been able to play through the pain this season but didn't make any progress toward my goals. I'll defer those til next year I guess. 

[BDAWG]

I'm dealing with a non-displaced hook of hammate fracture and a TFCC tear from golfing. Intially thought it was my wrist so I got Xrays/Ultrasound on wrist nothing found then they did a Ultrasound/Xray on Hand and nothing found finally I paid for an MRI and that's what was found. Doctor said to splint it for 4 weeks (Which probably wont help cause im already 4 months into the injury and still in pain) He referred me to a specialist so ill probably be waiting for half a year just to see one ( Im in Canada) Doctor said I can still work even know Im a tradesman and use this hand everyday... This injury has been terrible to deal with, took 4 months just to figure out what was wrong.. After reading this I really hope the Specialist opts do to Surgery but I lost all faith in our "free" healthcare and am concerned working with it will make things way worse and cause long term damage...

Edited November 30, 2024 by BDAWG

[Jbarretta]

Im really stuck now.  MRI 7 weeks ago confirmed non displaced hook fracture.  Came to these boards  Dr fought me tooth and nail not to do surgery and i accepted a cast for 6 weeks.  went for a 2nd opinion and they are aggressive and would operate asap.  Cast came off, lifted weights felt great.  played golf, agony.  basically played with one arm.   Ran and got a CT scan convinced there was non union, ready to call that 2nd dr for the surgery, then lo and behold, the CT scan says "mineralized bridging union is present throughout this injury"

 

Now i dont know what to do, i went from shooting 85-90 pain free to 110 in agony 8 out of 10 pain scale.