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What is Hamate Fracture
Hamate fracture is a break in a small wrist bone called the hamate. The hamate is located below and between your last two fingers (pinky and ring finger). It is shaped like a triangle and has a hook-like extension.
There are two types of hamate fracture:
- Type 1. This type involves the hook part of the bone.
- Type 2. This type involves the body of the bone.
What are the causes?
This condition may be caused by:
- A sudden injury, such as:
- Falling on an outstretched arm with a clenched fist.
- A crushing injury of the hand.
- A hard, direct hit (blow) to the hand.
- Overuse and stress from playing a sport with a bat, club, or racquet.
What increases the risk?
This condition is more likely to develop in people who:
- Play a sport with a bat, club, or racquet.
- Have weak or thin bones (osteoporosis).
What are the signs or symptoms?
Symptoms of this condition include:
- Pain in the palm of the hand.
- Pain when extending the last two fingers of the hand.
- A weak and painful grip.
- Swelling.
- Bruising.
- Numbness of the last two fingers.
- Inability to move the last two fingers.
- Pain when pressing on the hamate bone (tenderness).
If the condition is caused by a sudden injury, symptoms may develop right away. If the condition is caused by overuse or stress, symptoms may develop gradually.
How is this diagnosed?
This condition may be diagnosed based on:
- Your sports activity.
- Your history of injury.
- An examination of your wrist. When your health care provider examines your wrist, he or she will check to see if the movement of your fingers is limited or causes pain. He or she will also press on the bone to check for pain.
- An imaging test, such as MRI or a CT scan. This kind of fracture may be hard to see on an X-ray.
How is this treated?
Treatment for this condition depends on:
- Where the break is.
- How severe the break is.
- Whether the bone has moved out of place.
Treatment may involve:
- Surgery. Surgery may be needed to remove the hook part of the bone if it is broken, or to move a bone that has moved out of place into the right position.
- Wearing a cast or a splint to keep the wrist still (immobilized) while the bone heals.
- Icing the area to help with pain and swelling.
- Medicine to help with pain and swelling.
- Finger exercises to prevent stiffness.
- Physical therapy exercises to help improve the way that the wrist moves.
Follow these instructions at home:
If you have a cast:
- Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
- Check the skin around the cast every day. Report any concerns to your health care provider. You may put lotion on dry skin around the edges of the cast. Do not apply lotion to the skin underneath the cast.
- Do not let your cast get wet if it is not waterproof.
- Keep the cast clean.
If you have a splint:
- Wear the splint as told by your health care provider. Remove it only as told by your health care provider.
- Loosen the splint if your fingers become numb and tingle, or if they turn cold and blue.
- Do not let your splint get wet if it is not waterproof.
- Keep the splint clean.
Bathing
- Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
- If your cast or splint is not waterproof, cover it with a watertight plastic bag when you take a bath or shower.
Managing pain, stiffness, and swelling
- If directed, apply ice to the injured area.
- Put ice in a plastic bag.
- Place a towel between your skin and the bag.
- Leave the ice on for 20 minutes, 2–3 times per day.
- Move your fingers often to avoid stiffness and to lessen swelling.
- Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.
- Take over-the-counter and prescription medicines only as told by your health care provider.
Driving
- Do not drive or operate heavy machinery while taking prescription pain medicine.
- Ask your health care provider when it is safe to drive if you have a cast or splint on your hand or wrist.
Activity
- Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
- Do exercises as told by your health care provider or physical therapist.
General instructions
- Do not put pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
- Do not use any tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
- Keep all follow-up visits as told by your health care provider. This is important.
How is this prevented?
Tell your health care provider if you have hand pain or weakness while you swing a golf club or play a sport that uses a bat or racquet. These may be early symptoms of a hamate fracture. Early diagnosis offers the best chance for a quick recovery without surgery.
Contact a health care provider if:
- Your pain or swelling gets worse.
- You have pain or a cold feeling in your hand or fingers.
- Your cast or splint becomes loose or damaged.
Get help right away if:
- You lose feeling in your hand or fingers.
- Your fingers or fingernails turn blue or gray.