Conservative Treatment for Hook of Hamate Fracture: A Case Series of 18 Patients

Background The cause of hook of hamate fractures is either a fatigue fracture type because of repetitive stress on the hook of hamate from athletes involved in gripping sports (e.g., golf, tennis, and baseball) or a traumatic occurrence because of falls or other injuries. The recommended treatment involves the excision of bone fragments to facilitate athletes’ early return to sports; excision surgery is also performed in cases of trauma. However, some patients prefer nonsurgical treatment options, and conservative treatment should be considered. This study aimed to present a case series of 18 patients who were conservatively treated for hook of hamate fractures. Methods This study included 18 (13 males and 5 females, with 6 cases on the right side and 12 on the left) patients who desired conservative treatment and could be followed up until bone union was achieved. The average age of the patients was 49.7 (range, 24–72) years. The average time from injury to consultation was 4.7 (range, 0.2–21.4 weeks). The treatment involved 4 weeks of casting from the forearm to the metacarpophalangeal joint, followed by 8 weeks of splint fixation of the wrist. Follow-up computed tomography scans were performed every 4 weeks. Results Bone union was achieved in all patients. The average duration of casting was 3.3 (range, 0–5) weeks, and the average duration of splint fixation thereafter was 9.3 (range, 0–28) weeks. No complications were associated with cast immobilization. Conclusion Conservative treatment with external fixation may be an option for hook of hamate fractures.