J Korean Fract Soc.  2016 Jan;29(1):12-18. 10.12671/jkfs.2016.29.1.12.

Clinical Results of Excision of Hamate Hook in the Baseball Players with Hamate Hook Nonunion

• Lee SJ
• Lee JS

• KMID: 2183759
• DOI: http://doi.org/10.12671/jkfs.2016.29.1.12

Abstract

PURPOSE
The purpose of this study is to report the clinical results of excision of the hamate hook in baseball players with hamate hook nonunion.
MATERIALS AND METHODS
This study included 10 baseball players treated with excision of the hamate hook. Among 10 players, there were 3 professional players and 7 amateur players. The clinical outcomes were evaluated using the visual analog scale (VAS) pain score, exercise performance score, and grip power. We also checked complications and time to return to the game.
RESULTS
At final follow-up, the average VAS score was 0.4 points and the average performance score was 9.0 points. The grip power was recovered to 96.7% of the opposite hand at final follow-up. Significant improvement in pain and grip power was observed after surgery. The average time to return to the game was 11.8 weeks. There was one case of postoperative ulnar nerve neuropathy, which was completely resolved within 12 weeks after surgery.
CONCLUSION
We think that excision of the hamate hook is an effective treatment to enable early return to the game without loss of grip strength in the baseball player with nonunion of the hamate hook.

Keyword

Hook of the hamate; Nonunion; Excision

MeSH Terms

Baseball*
Follow-Up Studies
Hamate Bone
Hand
Hand Strength
Ulnar Nerve
Visual Analog Scale

Figure

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  Fig. 1 (A) Classification of hamate hook fractures. Number in parenthesis indicates number of patients. (B) Computed tomography-axial view shows nonunion of a hamate hook fracture (arrow).

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  Fig. 2 (A) A curved skin incision was made on the hypothenar eminence (asterisk: hamate hook). (B) After careful retraction of the superficial branch of the ulnar nerve (dashed arrow) ulnarly, the hamate hook (asterisk) and the deep branch of the ulnar nerve (arrow) can be found. (C) The hamate hook was removed carefully.

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  Fig. 3 The grip power was recovered to 96.7% of the opposite hand at the final follow-up. POD: Postoperative day.

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  Fig. 4 Location of the hamate hook relative to a bat end in the nondominant right hand of a left-handed hitter. H: Hamate hook, P: Pisform.

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