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Hook of hamate fracture
Often missed fracture despite classic history
A frequent athletic injury
Seen in stick sports (golf, baseball, hockey)
Typically caused by a direct blow (grounding a gold club)
https://upload.orthobullets.com/topic/6035/images/hamate_baseball.jpg
Patient presents with hypothenar pain and pain with tight gripping
https://upload.orthobullets.com/topic/6035/images/hamate_golf.jpg
Presentation may be subacute with longstanding wrist or palmer pain
Physical exam: Tender to palpation over hook of hamate
Specialized test: hook of hamate pull test
Supinated hand held in ulnar deviation. Ask patient to actively flex 4th and 5th digits against resistance at DIP.
https://www.youtube.com/watch?v=A-mjRnC1yWQ
Radiology: Consider adding carpal tunnel view to standard wrist series if diagnosis is suspected
CT sometimes needed to image the fracture
Tx: Immobilize in a short arm splint
References
https://eorthopod.com/news/new-test-for-sports-injury-of-the-hand/
https://www.orthobullets.com/hand/6035/hook-of-hamate-fracture