Fracture of the hook of the hamate bone Discussion

Fractures involving the hook of the hamate bone are often difficult to demonstrate with plain Xrays, and additional evaluation and management may be indicated based on clinical suspicion. Fractures of the hook of the hamate have a nearly 100% nonunion rate with conservative treatment. The problem may mimic a variety of other problems, including carpometacarpal or capitohamate joint disorders. Problems with this fracture include flexor tendon rupture from abrasion against the fractured hook area. Tendon rupture is a significant complication, often resulting in permanent disability despite multiple operations and extensive therapy. Other risks include ulnar neuropathy, persistent pain and failure of the fracture to heal. Conservative treatment runs the risk of tendon rupture, neuropathy and persistent pain which can greatly complicate the overall situation and result in poor hand function. Surgery to remove the fractured hook and inspect the tendons and nerves may minimize these risks. Specific surgical risks include tender scar, stiffness, numbness and arterial problems.

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