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Hook of hamate fracture

Diagnosis certain

A 63-year-old man with recent trauma

Hook of hamatefractures(also sometimes termed type 1 hamate fractures) are rare. They are a form of hamate fractures and occur from the hamate fracturing after blunt trauma, falls, and in sports players (e.g. golf, baseball, racquet sports) from a direct blow while swinging. Stress fractures have also been reported.
It may result in Guyon’s canal syndrome.
If occult on standard views, a carpal tunnel viewmay be of value for better assessment. CT can be considered if initial radiographs are negative. MRI is 100% sensitive and can be considered for high suspicion of injury.
This can be managed conservatively or with surgical excision or fixation depending on clinical status.

Snoap T, Habeck J, Ruiter T. Hamate Fracture. Eplasty. 15: ic28. Pubmed
Guha AR, Marynissen H. Stress fracture of the hook of the hamate. British journal of sports medicine. 36 (3): 224-5. Pubmed
Mariano O. Abrego, Franco L. De Cicco. Hamate Fractures. (2020) Pubmed
Davis DL. Hook of the Hamate: The Spectrum of Often Missed Pathologic Findings. (2017) AJR. American journal of roentgenology. 209 (5): 1110-1118. doi:10.2214/AJR.17.18043- Pubmed

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