Hook of Hamate Fractures in Major and Minor League Baseball Players

The purpose of this study was to describe an approach to surgical management of the hook of hamate fractures in professional baseball players.

A retrospective chart review was performed on Major and Minor League Baseball players who underwent surgical excision for the hook of hamate fracture between the years 2003 and 2019 by a single surgeon. Patient demographics, the mechanism and timing of the injury, diagnostic and operative details, postoperative complications, and timeline to return to baseball activities were recorded.

A total of 145 professional baseball players affiliated with 17 Major League Baseball organizations were studied, with the majority of athletes playing at the Minor League Baseball level (91.7%). Subacute or chronic patterns of injury (81.7%) were found to be more common than acute patterns based on radiographic and intraoperative findings. Two patients reported transient numbness in the fourth and fifth digits after surgery, 6 patients reported pisotriquetral pain when returning to a hitting program, and 1 patient developed heterotopic ossification after surgery. All complications resolved during a strength and conditioning program. On average, players in our cohort began a hitting program at 4.6 weeks after surgery and were released into full baseball activities at 7.1 weeks after surgery.

Surgical excision remains an effective method of management, with a low risk of minor complications for both acute and chronic hook of hamate fractures in professional baseball players.

Therapeutic Level IV.