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Hamate hook fracture (Read 5282 times)

Malcolm Smith

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Hamate hook fracture
January 18, 2004, 11:50:20 pm
I wonder if anyone has ever fractured the hook of the Hamate in their hand?I have been having chronic problems with this injury over the past 2 years.I'm ok outside but in comps or indoors on big holds its really holding me back.The surgeon said the only cure is to remove the now dead bit of bone.That could affect my strength though.Has anyone had this operation?Any feedback would be greatly appreciated.Malcolm

dobbin

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#1 Hamate hook fracture
January 19, 2004, 09:14:21 am
Never heard of anyone with owt like that to be honest - how did you do it?

Adam Lincoln

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#2 Re: Hamate hook fracture
January 19, 2004, 10:48:33 am
Quote from: "Malcolm Smith"
I wonder if anyone has ever fractured the hook of the Hamate in their hand?I have been having chronic problems with this injury over the past 2 years.I'm ok outside but in comps or indoors on big holds its really holding me back.The surgeon said the only cure is to remove the now dead bit of bone.That could affect my strength though.Has anyone had this operation?Any feedback would be greatly appreciated.Malcolm


Stick to small holds and stay away from the comps then  :wink:

Seriously, which exact bone is it, ive not heard of it?

Malcolm Smith

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#3 Hamate hook fracture
January 19, 2004, 11:23:52 am
The Hamate is one of the small bones at the base of the hand.It has a hook of bone coming of it which acts as a guide and increases the force of some flexor tendons.A bad one to break for a climber!Im not sure how I did it,it may just have been a stress fracture initially from over use.It seems to be the norm for these breaks not to heal due to poor blood supply(everyone knows about scaphoid breaks,thats a similar deal)Anyway I've read up about it on the web but theres nothing about climbing after an operation so I'm interested to know if anyone has done the same.

dave

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#4 Hamate hook fracture
January 19, 2004, 11:35:47 am
Apparently when they do those operations to avoid damaging the tendons they have to go in through the rectum.

dobbin

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#5 Hamate hook fracture
January 19, 2004, 11:54:01 am
Is that right? I sure hope I never break mine then.

Have a butchers at this:

http://www.sportsinjurybulletin.com/archive/wrist-tendinitis-treatment.html

"More than 50% of recreational rock climbers show signs of wrist tendinitis.18. In certain sports overuse tendinitis is considered normal and treatment is based on minimising the effects on the athlete. Peter Kormann, an Olympic gymnast stated that, ³All gymnasts work out and compete with ongoing problems in their upper extremities. These problems are only considered serious injuries when the gymnast can no longer compete². "

Theres loads of stuff Malc, google for 'hamate injury rock' or similar...

lleyton

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#6 Hamate hook fracture
January 20, 2004, 05:39:14 pm
although never believe 100% of what you read on the web, check this out -
http://www.eatonhand.com/dis/dis021.htm

talk of 'conservative treatment' means not operating on the fracture but treating it as best you can otherwise (prob what you've been doing so far). fractures lead to new bone growth, which can be disorganised if poorly aligned. this could abrade the flexor tendons - as mentioned - and would be bad news in the long run. in these cases i guess surgery could help you out a lot. ive not heard bout ne climbers havin it before, although im sure they have cos it seems like a ripe place for a fracture.

Malcolm Smith

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#7 Hamate hook fracture
January 20, 2004, 09:13:26 pm
Thanks Lleyton.I certainly need to find out as much as I can before I get an op.I'll persevere with it for now,cheers

fatboySlimfast

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#8 Hamate hook fracture
January 22, 2004, 09:56:53 am
I'll talk to the fatdoc tonight see what he says..
thought id done mine three months ago after loverrly somersault on me bike

TomP

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#9 Re: Hamate hook fracture
March 24, 2022, 03:50:33 pm
Hi all

Just resurrecting this old post.

I have a hook of hamate fracture too and, like Malc, the surgeon suggests the only solution is removal of the broken hook of bone. I'm currently awaiting a CT scan but the suspicion is total non-union of the bone.

Surgery can be very successful for athletes but evidence is based  on stick sports (golf, baseball etc) or gymnasts - not climbers. I've not seen any detailed information in climbers post-procedure.

I've been in touch with Malc who said it cleared up over another year or two with occasional flaring up. I've heard of similar stories of others with suspected fracture clearing up. However, I've also heard of many cases where pain persists for years until surgery is the only option.

Does anyone here have any experience of this injury or even undergone the surgery?

I'm taking a sabbatical from work in May with the intention of climbing full time. I've been planning it for years so terrible timing and I'm totally gutted.

I'd happily wait out the injury if I knew it'd improve. But, I'd also get the surgery if I knew the long time risk to reduced performance was very low - what a dilemma!

Cheers

Tom

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#10 Re: Hamate hook fracture
March 24, 2022, 05:58:59 pm
I broke my trapezium, obviously that’s not the same injury but it’s a similarly-sized carpal bone that’s just as rare to break.

It was kind of a high-energy burst fracture that the consultant said he’d never seen before. When I asked him to point it out on the x-ray he said “well, this is where it should be”  :'(

As I hadn’t “presented” it until a month after it had been done the only course of action was to leave it for four months and see how it developed. The options after that were

-just leave it as it is if I was managing OK.

-whip the whole remains of the bone out (he said he did this for patients on a weekly basis as it’s a fix for osteoarthritis of the thumb) the downside being that it would lead to a tangible and permanent loss of (what climbers call) pinch-grip strength.

-Pioneering surgery to remove part of the bone remnant and refashion the rest into a working surrogate. As you can imagine this was his preferred option and he was probably planning the journal article and presentation in his head as he was suggesting it  ;).

I was deeply sceptical that the first option would happen as at that point I could barely pinch a glass of water and the pain was terrible but over the course of the four months the raw surfaces of the bone healed and my hand just adapted to the new configuration. It looks a bit wonky (the thumb kind of “lives” in front of my palm now- it’s permanently in a narrow hand jam position) but I very rarely have pain from it, I didn’t need an operation and I can do everything I used to, including climbing. I’m sure if you did measurements on me my left hand would be weaker than the right but, I mean, Tommy Caldwell’s got a missing finger.

So if the option to wait and see is there, take it and hopefully you’ll have an outcome like mine.  :thumbsup:

TomP

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#11 Re: Hamate hook fracture
March 24, 2022, 06:36:33 pm
Great, thanks useful to know and glad you've made a decent recovery.

Time is a great healer as you say - but also at total bitch when you're raring to go!

 

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