Hook of Hamate Fracture - Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубликовано: 18 дек 2014
- Dr. Ebraheim’s education animated video describing Hook of Hamate fractures.
The hamate is one of the many carpal bones of the hand and wrist. The hamate bone is a triangular bone located in the distal carpal row situated on the ulnar side of the hand. The hamate is composed of a body and a hook. The ulnar nerve passes through the Guyon’s canal between the hamate and pisiform bones. The ulnar nerve can become injured by a fracture of the body (rare) or by a fracture of the hook (common) which may cause neuropathy of the ulnar nerve within the Guyon's canal.
Hamate fractures are classified as either a hook fracture (common) or as a body fracture (Rare). Missing the fracture can lead to persistent pain from nonunion. Hamate hook fractures are most often seen in racquet, bat or club sports such as hockey and golf.
Fractures of the hamate bone are difficult to diagnose, and routine x-rays may not show the fracture. Hook fractures of the hamate are best seen by carpal tunnel x-ray views. Rule out ossification center (os hamuli proprium). For hamate fractures CT scan is the best study.
Clinical evaluation
•Hypothenar pain
•Pain and paresthesia of the ring and small finger from ulnar nerve compression in the Guyon’s canal.
•May be weakness of the intrinsics (ulnar nerve compression in the Guyon’s canal)
•Decreased grip strength.
•The most common findings is pain and tenderness on the ulnar side of the wrist distal to the wrist joint.
Pull test is recently described. The palm of the hand is placed into supination. The wrist is in full ulnar deviation. Fingers of the patient should be flexed. The examiner pulls on the ulnar two digits with the patient resisting the pull. A positive test with pain in the area of the hook indicated a fractured hook of hamate injury.
Differential diagnosis
Pisiform fracture
Check the hamate hook for a fracture. F the ulnar side hook is normal, then check the pisiform bone. May need to get a CT scan.
Treatment
•Acute fracture: early immobilization for acute fractures for 4-6 weeks to avoid nonunion
•Symptomatic nonunion of the hook of hamate: excision of the fracture fragment. ORIF is rare.
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Background music provided as a free download from RUclips Audio Library.
Song Title: Every Step
Thank you very much for sharing D. Ebraheim. Hamdoulilah
Excellent presentation.
thanks for the video sir.
Thank you for the information! Just had an MRI showed extensive bone marrow edema in the entire hamate bone. It's an old injury, been complaining for over a year... just had a CT scan
Tell me how is it as mine says same tell line of treatment
Clinicaly relevant anatomy. U r blessed teacher
Chukran jasilan!
thank you Dr Ebraheim have a nice day sir
Excellent video
Thank you!
Thanx
Ty ....:-)
Hi I have a fracture on the hamate hook it has been over 3 months now . What is the best solution a surgery or just a cast ?
I bat lefty and usually pull the ball. They put a heavy shift on me so I decided to hit opposite field. As soon as I hit & go to drop the bat, my hand gets the most excruciating pain & I can't hit at all as I can't grip the bat any longer..nor can I pull it around. On top of my hand there is now a hard, raised area that popped up immediately after.
Dr. Ebraheim, I hit a few fat golf shots and now am experiencing a little bit of hypothenar pain. Pressing directly on the hamate results in a little discomfort, and the pull test doesn't significantly increase this discomfort (gives a little relief in fact), but pressing on the area between my ring and pinky finger metacarpals (somewhat proximally to the wrist) produces a tingly feeling.
Is pressing in the above manner simply compressing the ulnar nerve? I have been looking up information to see what matches my symptoms (I know I probably shouldn't too much) when I learned about hook of the hamate fractures. The pain isn't constant or anything, just enough that when using my hands I am reminded it is there. Are sprains in this area more common than fractures?
I just don't want to make it worse, or fight through it when I could be RICE-ing it. Barring any advice I might get from your reply, that is the plan for the time being. Thanks for the video!
I have similar to you. How did yours heal up?? Wondering because your comment was 3 years ago. Any help would be appreciated
How bad is it to leave a hook of hamate fracture completely undiagnosed and untreated?
Just curious. I fell forward and landed on my right hand. I've broken a leg before, so I expected that if I broke anything I'd get swelling and bruising. I did get bruising all over the palm of my hand, and I've had trouble with some uses of the hand, but other uses are fine. But the heel of my hand is just aching abominably all the time. I have trouble opening doors, shifting gears in my car but the pain has been racheted up every day. I did the two finger pull test as described in this video and got pain. I realize you won't answer but thought I'd organize my thoughts in this way. I do wonder how common is it for the pain to get worse rather than better.
Sir, i had this surgery done about 2 months ago. I'm a baseball player and also a switch hitter.. Since the surgery till this day i still have not been able to swing the bat left handed, i had the hook removed out of my right hand. Why does it still hurt ?
does it still bother you or has it resolved by now?
I got told off doctor and letter saying about hook and hamate break, got in cast 3 weeks, do thay put you a sleep to remove or fix it thanks if any 1 can help me
Just had the procedure today actually, they put you to sleep
Can this pain occur due to punching or fighting?
I have the same question. It hurts like hell! Getting an MRI done in two weeks
I just got mine extracted . Any questions you an ask me . Had surgery less then 3 days ago .
I have a similar problem. My hand also has been hurting for a while specifically on the hook of hamate. The injury happened mid november and I only started putting a cast on several weeks back. My hand feels slightly better but as soon as I put some pressure on it again it starts to swell. Please get back to me on what you did cause I asked several doctors and no one benefited me.
@@hussainabdalla2372 The only thing you can do is to visit an orthopedic and they will deside . But if is the hook of the hamate the only way to fix it is extracting the bone , the cast dont solve the problem because the bone will never heal by itself .
@@hussainabdalla2372 what treatment was done to your hand
Is extraction recommended for hairline fractures as well?
@@cubanson83 how was the recovery
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