Hamate fractures may involve the body of the hamate, the hook of the hamate, or any of its articular surfaces. Body fractures are rare and are generally associated with fracture/dislocations of the fourth or fifth metacarpals. Most hamate fractures involve the hamate hook, which is a small bony prominence on its volar side. The classic mechanism is an interrupted swing with golf club, bat, or racquet. The handle impacts against the hypothenar eminence and compresses the bone. The hook of the hamate is palpable in the soft tissues of the hypothenar eminence, just 1 cm distal and at a 45-degree radial angle from the pisiform. There will be localized tenderness here. Standard and carpal tunnel views are necessary to visualize the fracture. Occult fractures may be visualized by bone scan or computed tomography. These injuries are treated with compression dressing or splint. Nonunion is common and excision of the bone may be necessary. Injury to Guyon's canal and the ulnar nerve or artery are potential complications.
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