Nonoperative treatment of acute hamate hook fractures

Six patients with acute and two patients with subacute nondisplaced fractures of the hamate hook were treated with immobilization. The patients with acute fractures were treated within 7 days of the injury, and those with subacute fractures were treated after 7 days. Seven of the eight patients showed documented healing of their fractures. At follow-up (average 8 months) all seven were free of symptoms. One patient with a subacute fracture did not comply with treatment and had a painful nonunion. Our results show that hamate hook fractures that are diagnosed early may heal with nonoperative management. Fractures that fail to heal with immobilization or those with chronic nonunion should be treated with excision of the hook fragment.