Question 1

I'm a baseball player with wrist pain for 2 months that was diagnosed as a 'wrist sprain' - could it be a hook of hamate fracture?

Accepted Answer

Quite possibly - hook of hamate fractures are frequently misdiagnosed as wrist sprains because: (1) Symptoms are non-specific (ulnar-sided wrist pain, similar to many wrist injuries); (2) Standard wrist X-rays appear normal in 50-60% of cases because the hook is small and overlapped by other bones on routine views; (3) Many doctors unfamiliar with this injury (uncommon outside athletes). SUSPECT HOOK OF HAMATE FRACTURE IF: You're a baseball batter, golfer, or racquet sport player | Pain started after batting/swinging or direct palm impact | Pain on little finger side of wrist, in palm | Point tenderness when pressing on palm at base of little finger | Weak grip, difficulty holding bat | Pain not improving despite rest and 'sprain' treatment. REQUEST SPECIFIC TESTING: (1) Physical examination - ask doctor to press on hook of hamate in palm (sharp pain is positive sign); (2) CT scan of wrist - this is the gold standard test and will definitively show hook fracture if present. Don't accept 'wrist sprain' diagnosis if pain persists beyond 3-4 weeks—push for CT scan. Many athletes have suffered months of unnecessary pain and delayed return to sport because hook fracture not diagnosed promptly. Once correctly diagnosed, treatment (usually hook excision surgery) provides excellent results with return to sport in 6-8 weeks.

Question 2

If I have surgery to remove the hook of hamate, will my wrist work normally or will I have permanent weakness?

Accepted Answer

Excellent question - intuitively it seems wrong to remove a piece of bone, but the hook of hamate is unique in that removing it does NOT significantly affect wrist function or strength. The hook is primarily an attachment point for two small muscles (flexor carpi ulnaris and opponens digiti minimi) and a ligament (pisohamate ligament). When removed, these structures simply attach to remaining bone or scar tissue and function is maintained. RESEARCH EVIDENCE: Multiple studies of athletes (especially professional baseball players) who had hook excision show: (1) 90-95% return to pre-injury level of sport; (2) Grip strength recovers to 95-100% of opposite hand; (3) No measurable decrease in wrist range of motion or stability; (4) Athletes report no functional limitations and can't tell which wrist had surgery years later. RECOVERY TIMELINE: Immediate pain relief after surgery, gradual grip strengthening over 6-8 weeks, return to competitive sport at 6-8 weeks. Some athletes report they wish they'd had surgery earlier rather than trying to play through pain or attempting cast treatment (which often fails). The key message: hook excision is a highly successful, low-risk procedure that allows athletes to return to full sport participation pain-free. The alternative (leaving a painful nonunion in place or trying to heal it with casting which has 50% failure rate) results in prolonged pain and often delayed return to sport anyway when surgery eventually needed.

Medical Disclaimer

Broken Hamate Bone (Wrist Fracture in Athletes)

📖What is Broken Hamate Bone (Wrist Fracture in Athletes)?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention