Paging Dr. Rosenrosen – Hamate Bone Fractures
Up until about 5 years ago, I never heard of the hamate bone. But now it seems like every month or so you hear about a player needing to have his hamate bone removed. This hit home last week with the news that rising prospect Robbie Grossman had his Arizona Fall League season cut short by fracturing his hamate bone. You usually hear the same standard quote about the hamate bone surgery: “After removal, this will sap the player’s power potential in the short-term, but the player will be fine in the long-term.” I was curious about the hamate bone and did a little research on the subject.
Where is the hamate bone? If you take either hand and turn it over so the palm is facing up, the hamate is at the bottom of the ring finger where it meets the metacarpal bones, just above the wrist.
What does “hamate” mean? Hamate is Latin for “hooked”. The hamate is wedge-shaped in nature, with a small hook protrusion on the back side of the bone.
How does a hamate bone fracture? If you were like me, you may have thought that hamate bone fractures were due to the player getting hit by a pitch. While that may be true in some cases, what happens most of the time is that the player overswings or swings and makes blunt impact with a stationary object. When the bat is stopped by this stationary object, the force is transmitted through the wrist closest to the point of contact (typically the non-dominant hand) and the fracture occurs. It seems the majority of hamate fractures among athletes are by golfers swinging and hitting into the ground when striking the ball.
What are the symptoms of a hamate bone fracture? Any type of action involve gripping will cause pain to flare. The hamate is also connected in some fashion to the ulnar nerve system that runs the entire length of the arm, so any flexing of the pinkie or ring finger will cause pain.
Is the whole hamate bone removed? No, although it is sure perceived that way during most reports. What is removed is the hook portion of the bone. The remaining wedge stays in place.
Apparently in the past the treatment was to place a small cast on the hand and forearm and hope that it healed naturally in 6 weeks. However, studies were showing that greater than 50% of the fractures were still “non-union”, so the surgical option came into play. Flexor tendons in the hands can also be prone to rupture if the hook continues to irritate the situation.
All reports are saying that Grossman should be healed by Spring Training and ready to resume normal baseball activities.