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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