Pain on the little-finger side of your palm is keeping you from work, sports, or everyday tasks? A hamate fracture could be the reason. Below, you’ll find an easy-to-read guide to this often-overlooked injury, including how we quickly identify it and the treatment options that help our patients get back in action fast.
What is the hamate?
The hamate is one of eight wrist (carpal) bones. It sits on the ulnar—or pinky-finger-side and has a tiny forward-facing hook (called the hamulus). That hook forms part of the walls of two key tunnels in the wrist—Guyon’s canal (housing the ulnar nerve and artery) and the carpal tunnel (for the median nerve). Because tendons, ligaments, nerves and blood vessels all brush past it, a break here can cause big trouble in a small space.
Types of hamate fractures
Type | How it happens | Who it’s common in |
Hook (hamulus) fracture | Direct force or repeated impact on the palm (club, bat, racquet, barbell) | Golfers, baseball & cricket batters, racket-sport athletes, weight-lifters |
Body fracture | Higher-energy blows, falls, punching injuries or car crash forces | Contact-sport athletes, industrial accidents, road-traffic collisions |
Hook fractures make up roughly 70 % of all hamate injuries—and because they hide on routine X-rays they’re the ones most often missed.
Signs & symptoms
- Aching or sharp pain in the fleshy “hypothenar” pad of the palm
- Tenderness when you press just beyond the crease at the base of the little finger
- Pain or weakness when gripping, swinging a bat/club, doing push-ups or turning a key
- Numbness, tingling or electric shocks in the ring and little fingers (ulnar-nerve irritation)
- Pain when you bend the ring or little finger against resistance (the Hook-Pull Test)
If these symptoms linger more than a week after the injury, you deserve a specialist review.
Fast & accurate diagnosis at The Arm Doc
- Focused examination – we know the subtle tests that make a hook fracture hurt.
- Targeted imaging
- Carpal-tunnel X-ray view – a tangential angle that shows the hook head-on.
- In-office cone-beam CT – our gold-standard scan, catching nearly 100 % of fractures (even hair-line cracks other scanners miss).
- High-resolution MRI when soft-tissue, nerve or blood-supply questions remain.
- Same-day feedback – no waiting weeks for answers; you leave with a clear plan.
Early detection matters. Studies show delays over two months triple the risk of tendon rupture or chronic non-union.
Treatment options
Approach | Best for | What to expect |
Protective splint or cast (4–6 weeks) | Fresh, non-displaced fractures | Wrist and fingers immobilised; follow-up CT to confirm healing; return to sport 8–12 weeks |
Mini-incision screw fixation (ORIF) | Displaced hook or body fractures in patients who want to keep the bone intact | Tiny headless screw restores normal anatomy; 4–6 weeks in brace; full grip by 10–12 weeks |
Hook excision (our most common athlete option) | Painful non-union or acute fractures in pros who need speed | 15-minute outpatient procedure; stitches out at 10 days; swinging a bat/club in 3–4 weeks |
We’ll walk you through the pros, cons and recovery timeline so you can choose with confidence.
Why choose The Arm Doc?
- Sports-medicine focus – We treat professional golfers, baseball players, climbers and weekend warriors alike, tailoring care to your season, tournament schedule or job requirements.
- Cutting-edge imaging on site – saves multiple appointments and speeds decisions.
- Ultra-minimally invasive techniques – smaller scars, less pain, faster return.
- In-house hand therapy team – therapists start motion exercises the day your splint comes off; they’ll coach you from gentle range-of-motion all the way to power grip and sport-specific drills.
- One-call access – injuries don’t wait, and neither should you. Call before 10 a.m. and we’ll see you today.
Recovery & rehabilitation roadmap
- Protection (Week 0-2)
- Splint or light dressing, keep incision dry.
- Wiggle fingers hourly to prevent stiffness.
- Early motion (Week 2-4)
- Guided finger and wrist stretches.
- Scar massage, nerve-glide exercises if tingling persists.
- Strength & coordination (Week 4-8)
- Putty and hand-grip drills, progressive resistance bands.
- Sport-specific grip patterns: bat knob, club handle, racquet grip.
- Return to full play (After Week 6-10)
- Gradual re-introduction of full swings, push-ups, heavy lifts.
- Final clearance once grip strength equals the uninjured side and imaging confirms solid healing (or pain-free function after excision).
Call to Action
If you have pain, book an appointment to be reviewed by Prof Imam or another member of our specialist team at The Arm Clinic. Early specialist care helps prevent long-term issues. Visit www.TheArmDoc.co.uk or book your consultation today. Phone: 020 3384 5588 | Email: Info@TheArmDoc.co.uk
Disclaimer
This information is for general educational purposes and should not be used as a substitute for professional medical advice. Consult a healthcare professional for individual guidance on your condition and treatment options.
This page was last clinically updated in May 2025