Wrist | Carpal fractures | Golf-induced hamate hook fracture

56-years-old patient, regular golfer, consults for hypothenar eminence pain left for 3 months.

Figure 1: MRI of the left wrist, axial sequences ponderate DP Fat-Sat (A) and T1 (B). Hook base fracture of the hamate (yellow arrow), with inter-fragmentary diastasis of 3mm. Trabecular edema of the hamate bone (red star). Note the absence of incarceration of flexor tendons within the fracture site.

Figure 2: left wrist CT-scanner: axial (A) and sagittal (B) views. Hook basal fracture of the hamate, without individualizable bone callus. The fracture banks are clear, non-corticalized.

The wrist is one of the most traumatized anatomical regions among golfers with attacks: 

-bone lesion (hamate fracture, triquetrum fracture, metacarpal fatigue fracture) 

-tendinous (tendinopathy / tenosynovitis / rupture of extensor digitorum longus, extensor carpi ulnaris, De Quervain) 

-Ligamentary (TFCC complex lesions).

The hook fracture of the hamate bone is one of the most common attacks on the golfer. The treatment can be conservative or surgical depending on the sports level and of the inconvenience. Surgical treatment would be associated with a faster regression of local pain.

 

References:

-Clinics in diagnostic imaging (156). Golf-induced hamate hook fracture. Tan HK, Chew N, Chew KT, Peh WC. Singapore Med J. 2014 Oct;55(10):517-20

-Hook of the hamate fracture. Gill NW, Rendeiro DG. J Orthop Sports Phys Ther. 2010 May;40(5):325.

-Hook of the hamate fractures in competitive golfers: results of treatment by excision of the fractured hook of the hamate. Alridge JM 3rd, Mallon WJ. Orthopedics. 2003 Jul;26(7):717-9