Epidemiology

Hamate fractures represent a small portion of carpal fractures, accounting for approximately 2-4% of all carpal injuries. They most commonly occur in individuals aged 20-40 years, with a higher prevalence in males due to increased participation in contact sports and manual labour, which are common causes of this type of injury.

Athletes, particularly those involved in sports requiring a strong grip on equipment, such as golf and baseball, are at an increased risk. This is due to the repetitive stress and direct blows to the ulnar side of the palm, which can lead to a hook of hamate fracture.

PC

Patients with hamate fractures often present with the following signs and symptoms:

• Persistent pain in the wrist, particularly on the ulnar side
• Limited range of wrist movement
• Decreased grip strength
• Tenderness over the 'hook' of the hamate
• Swelling and bruising in the wrist region

Investigations

• x-ray
• If initial X-rays are inconclusive but clinical suspicion remains high, a CT scan or MRI may be utilised for further evaluation.

Management

• The primary mode of treatment for hamate fractures is typically conservative, involving immobilisation of the wrist using a cast or splint. However, this approach carries a high rate of malunion due to the unique anatomical position and blood supply of the hamate.
• If conservative management fails or the fracture is severely displaced, surgical treatment may be required. This could involve excision of the fractured fragment of the bone or internal fixation using screws or pins.