A hamate bone break is a small fracture in the wrist that often affects baseball players and other athletes who swing rackets or clubs. It can also happen after a fall or direct impact to the hand. This injury is treatable and many people, including professional athletes, recover fully with the right care.
Where is the hamate bone?
The hamate bone is one of eight small bones that make up your wrist. It's located on the pinky (ulnar) side of your hand.
“Many ligaments attach to the hamate bone, nerves pass on either side of it and it plays an important role in our grip,” said Andrea Morley, MD, a sports medicine specialist with Banner - University Medicine.
This bone has a unique projection, called the hook of the hamate. This hook sticks out toward the palm, which puts it at risk of injury.
How do hamate bone breaks happen?
Most hamate fractures involve a break in the hook portion of the bone. These breaks usually happen in one of two ways:
In baseball and other sports: Forcefully swinging a bat, racket or club often causes this injury, which is common for professional athletes in baseball, golf and tennis. The handle puts pressure against the palm and a sudden force, like a check swing or a foul tip, can snap the bone. In baseball catchers, the force of fast pitches can break the hamate bone.
Outside of sports: You don't have to be an athlete to break your hamate bone. A fall onto an outstretched hand, a car accident or a direct blow to the palm of the hand can also provide enough force to break the hook.
What are the symptoms of a hamate fracture?
The most common sign of a hamate break is pain in the center or toward the pinky side of the palm.
Other symptoms include:
- Weak grip strength
- Pain with gripping, grasping or pushing
- Pain when swinging a bat
- Pain when holding objects or doing activities that put pressure on the palm
- Tingling or numbness in the ring and pinky fingers, which happens because of nerve irritation
- Pain that doesn’t get better when you rest your hand
You may want to see a doctor if you have:
- Wrist pain that lasts more than a few days
- Pain when you’re rotating your wrist
- Trouble gripping objects
- Fingers that feel numb
Why are hamate fractures sometimes missed?
“With a hamate break the pain isn't always severe, so you might think you only have a wrist sprain or a bone bruise,” Dr. Morley said. And because the hamate bone is so small, these fractures are sometimes hard to see on a standard X-ray, even with specific views designed to evaluate it.
If a specialist suspects a break, they may order imaging like a CT scan or MRI to get a better look.
How are hamate bone breaks treated?
Your health care provider will recommend a treatment plan based on how bad the break is and your activity level.
Nonsurgical treatment
Many hamate fractures heal without surgery. Treatment usually involves:
- Stabilizing the wrist with a splint or cast
- Pain management
- Resting the hand
- Avoiding activities that could slow healing
Surgical treatment
Surgery is common for competitive athletes and for fractures where the bone fragments have separated.
The surgeon removes the fractured hook portion of the bone, which usually doesn’t affect long-term hand function and can get athletes back in the game.
How long does recovery take?
Recovery time is different for everyone. If you don’t have surgery, you may need to wear a cast or splint for four to six weeks. Your provider will use X-rays to see how the bone is healing.
After the cast or splint comes off, you may need a removable brace for a week or two, then four to six weeks of physical therapy. Hand therapy focuses on stretching and strengthening exercises that help you regain your strength, function and mobility.
After surgery, athletes will collaborate closely with their physician to get back to their sport as soon as possible. Once they can return, it may take some time to get back to their earlier performance level.
Can you prevent a hamate bone break?
While you can't prevent every accident, you can lower your risk:
- Grip equipment properly: Make sure you aren't holding your bat or club in a way that puts too much pressure on your palm.
- Use equipment that fits well: Your gear should be the right size for your hands.
- Wear protective gloves: Padded gloves can help absorb the shock of the bat, racquet or club.
- Strengthen your muscles: Keep your hand and forearm muscles strong to better support the wrist joint.
When should you see a specialist?
Whether you’re an athlete or not, it’s a good idea to see a specialist for:
- Ongoing pain on the pinky side of your wrist
- Numbness
- Weakness
- Trouble using your hand for daily activities
The bottom line
A hamate bone break is a wrist injury that’s common in athletes who play baseball, softball, tennis or golf but it can happen to anyone. Recognizing symptoms early and getting the right care can help you recover and return to the activities you enjoy.
If wrist pain is keeping you from playing the sports you love or doing everyday tasks, a Banner Health specialist can help you get answers and a treatment plan.
FAQs about hamate bone fractures
What is a hamate bone fracture?
It’s a break in a small wrist bone on the pinky side of your hand.
Why is it common in baseball players?
Forceful bat swings and pressure from the handle can stress the bone.
Can a hamate fracture heal without surgery?
Some cases can heal with rest and immobilization but some athletes may need surgery.
How long does it take to recover?
Recovery can take several weeks to months, depending on the treatment you receive.
