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Healing Hamate Fractures: From Cast to Comeback
Published: Aug 06, 2024
Treating a hamate fracture isn't a one-size-fits-all approach. From conservative care to surgery, the path to healing depends on the specific injury and the patient's needs.
Conservative Care: When Casts Come First
For many hamate fractures, especially non-displaced ones, treatment starts with immobilization. A short arm cast that includes the ring and little fingers is typically used. The wrist is placed in slight flexion to reduce tension on the hamate hook. This cast stays on for 4-6 weeks, sometimes longer for hook fractures.
Surgical Solutions: When Casts Aren't Enough
Surgery may be necessary for displaced fractures, fracture-dislocations, or cases that don't improve with casting. For hook fractures, excision (removal) of the fractured piece is common, especially in athletes needing a quick return to play. Some surgeons may attempt to fix the fracture with small screws instead.
The Comeback Trail: Rehabilitation and Return to Activity
After the cast comes off, the real work begins. Patients typically start with gentle stretching exercises to regain mobility. Strengthening exercises follow as healing progresses. For those who've had surgery, return to full activity often takes 6-7 weeks, though some may need up to 3 months.
Special Considerations for Athletes
Athletes, especially in sports like baseball or golf, may opt for early surgical intervention to speed return to play. After surgery, they often use protective splinting during activities for several months. While most return to their previous level of competition, it's not guaranteed – about 15-20% may face challenges in returning to the same level of play.
Frequently Asked Questions
Typically 4-6 weeks, but some hook fractures may need up to 12 weeks.
Often yes, especially after prolonged immobilization or surgery.
It depends on the sport and your doctor's advice; some activities may be possible with protection.
It varies, but many can return to light duty within a few weeks.
Minimal; most patients regain full function, but discuss potential risks with your surgeon.
The Path Forward
With proper treatment and dedication to rehabilitation, most patients with hamate fractures can expect a full recovery.
References
- Whalen JL, et al. J Hand Surg Am 1992; 17:507.
- Bansal A, et al. J Hand Surg Am 2017; 42:803.
- Erickson BJ, et al. Am J Sports Med 2020; 48:3066.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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