The hook of hamate may be fractured while striking the ground with a stick or making a divot playing golf. Clinically, this fracture is suspected by tenderness over the hook of hamate in the palm. It is also indicated by pain on resisted flexion of the little finger, which localizes to the region of the hamate. X-ray or CT of the carpal tunnel confirms the diagnosis. Treatment of the nondisplaced fracture requires open reduction and fixation, or excision, of the fragment.
Subungual hematoma indicates a nail bed laceration.
These open fractures require irrigation, repair of the nail bed with fine sutures, and replacement of the nail plate to act as a splint. Large displaced fractures are held with a K-wire. Hyperesthesia frequently persists long after the fracture has healed, requiring desensitization techniques. All rights reserved.