• Broken Hand
  • NSAIDS: To Use or Not to Use
  • Hydrocele, Spermatocele and Strained Groin
  • Hand: Arthritis
  • Open-Heart Surgery
  • Osteopenia and Increasing Bone Density
  • Body: Pain Meds vs Sex
  • Appendectomy and Climbing Training
  • Body: Injury Truths
  • Body: BPA and Waterbottles
  • Body: Bouldering for Bone Density
  • Body: Chronic Injury
  • Body: Bouldering for the Bones
  • Body: Antibiotics and Tendon Damage
  • Back

  • Lumbar Bone Spurs
  • Options for Disc Herniation
  • Back: Spinal Fracture
  • Back: Preventing Hunchback
  • Back: Herniated Disc
  • Abdomen

  • Abdomen: Muscle Tear/Hernia
  • Arm

    No items found.


  • Thoracic Musculature Tightness
  • Chronic Posterior Shoulder Pain
  • Supraspinatus and Labral Tears
  • Chronic Shoulder Pain
  • Shoulder Replacement
  • Shoulder Pain
  • Exploding Shoulder
  • Shoulder: Thoracic Outlet Syndrome
  • Shoulder: SLAP Lesion and Cortisone
  • Shoulder: Frozen Shoulder
  • Shoulder: Torn Labrum, SLAP Lesion
  • Shoulder: Separation
  • Shoulder: Pain and Virus
  • Biceps

  • Bursting Biceps
  • Elbow

  • Golfer's Elbow
  • Elbow: Brachioradialis Pain
  • Tennis Elbow
  • Medial Epicondylosis Tendonitis
  • Dodgy Elbows Revisited
  • Synovial Chips
  • Quack Elbow Treatments to Avoid
  • Elbow Pain and Cortisone Use
  • Do Compression Sleeves Work?
  • Elbow: Tennis Elbow
  • Elbow: Medial Tendonosis
  • Elbow Pain and Dodgy Elbows
  • Elbow: Tendonosis
  • Elbow: Medial Epicondylosis and Taping
  • Elbow: Tingling and Numbness
  • Elbows: Minimizing Fingerboard Injuries
  • Elbow: Medial Epicondyle Tendonosis
  • Elbow: Stress Fracture
  • Elbow: Pain and Hangboarding
  • Wrist

  • TFCC Tear
  • Wrist Pain From Cleaning Routes
  • Wrist: Klienbock's Disease
  • Wrist: Ruptured Tendon
  • Snap, Crackle, Wrist
  • Wrist: Fractured Scaphoid
  • Wrist: Instability
  • Hand

  • Broken Hand
  • Hand: Hook of the Hamate Fracture
  • Fingers: Everything You Need to Know About Finger Stress
  • Hands: Dupuytren's Disease (lump in palm)
  • Hands: Numbness and Carpal Tunnel Syndrome
  • Fingers

  • Swollen Right Index Finger
  • Pinky Numbness
  • Avulsion Fracture
  • Hand: Arthritis
  • Finger Numbness
  • Fourth Metacarpal Break
  • First Pulley Strain
  • Freezing Fingers Today, Benefit Tomorrow?
  • Cysts in Fingers
  • Ruptured Finger Pulley
  • Major Finger Pain
  • Fingers: What To Do with a Ruptured Flexor Digitorum Superficialis
  • Fingers: Everything You Need to Know About Finger Stress
  • Fingers: Hyper-extended
  • Fingers: Cysts and Pain
  • Fingers: Cracked Fingertips
  • Fingers: De Quervain's Tenosynovitis
  • Fingers: NSAID Treatment
  • Fingers: Torn A2 Pulley
  • Fingers: Trigger Thumb Syndrome
  • Fingers: Stiffness, Soreness
  • Fingers: Grip Position and Injury
  • Fingers: Cortisone for Tendon Injuries
  • Fingers: Pinky Finger Pain
  • Fingers: Electrostimulation
  • Hands: Numbness and Carpal Tunnel Syndrome
  • Fingers: Taping Truths
  • Fingers: Flappers
  • Fingers: Trigger-Finger Syndrome
  • Fingers: Torn A3 and A4 Pulleys
  • Fingers: Cysts
  • Fingers: Arthritis
  • Fingers: Numbness
  • Fingers: Blown Tendons
  • Leg

  • Leg: Achilles Tendonitis
  • Leg and Knee: Broken Femur and Shattered Kneecap
  • Leg: Pulled Hamstring
  • Leg: Fracture
  • Knee

  • Outside Knee Pain: Tibiofibular Joint
  • MCL Injury
  • Blown Knees
  • Knee Tendonitis after Ankle Fusion
  • Meniscal Tear on a Drop Knee
  • Knee: Rockfall Causes Lump
  • Knee: Chondral Injury of the Lateral Tibial Plateau
  • Leg and Knee: Broken Femur and Shattered Kneecap
  • Knee: Ruptured ACL
  • Knee: Ruptured Ligament and Meniscus
  • Knee: Synovial Cartilage Damage
  • Ankle

  • Osteochondral Talus Fracture
  • Knee Tendonitis after Ankle Fusion
  • Snapped ankle tendon
  • Possible Death of the Talus Bone
  • Broken Talus Bone
  • Ankle: Loud Pop Ankle Roll
  • Feet

  • Bunions
  • Dr. J Attacks Fungal Toenails
  • Feet: Broken Foot
  • Feet: Gout and Pseudogout
  • Feet: Toe Fracture
  • Video Spotlight
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    Hand: Hook of the Hamate Fracture


    X-rays don’t always reveal broken bones, especially difficult-to-spot ones like the Hook of Hamate bone in your hand. Illustration courtesy of Steve Graepel.I was climbing a vertical face in the Grampians, and the crux move was a dyno. I missed, and fell awkwardly, impacting the cliff with my left hand. The pain was immediate and intense, directly below my pinky at the bony protrusion. I was unable to climb, or even belay for the rest of the day. Two days later, I went to my doctor, and by then the finger was swollen and blue. My doctor said I hadn’t broken anything, probably just had soft-tissue damage, given the amount of bruising, and sent me home. Ten days later, x-rays showed no fracture. Ten weeks have now passed, and climbing is still prohibitively painful. Any pressure over that area, like mantling or riding a bike, causes a wave of pain. Crimping also creates a lot of discomfort.

    — Emma Carr, Forum

    You could not even belay?!X-rays are great, but you need the right ones and, going by your GP’s approach, it does not sound like you have had them. Impact to the base of your palm on the little-finger side that results in severe pain, let alone with ongoing severe pain, is indicative of a fracture to the Hook of the Hamate bone. In a normal series of wrist x-rays, the Hook of the Hamate is superimposed over the body of the Hamate bone, and hence you are unable to appreciate any fracture of it. Your doctor would need to order a particular x-ray view that demonstrates this bone.

    Crimping hurts because you are basically doing an orthopedic test known as the Hook of Hamate Pull Test. If you curl your pinky and ring fingers into a crimp position and even slightly bend your wrist to the ulna side (toward the pinky), the tendons involved in flexing those fingers press on the hook part of the Hamate bone. If it’s fractured, you feel acute pain.

    Hook of Hamate fractures are not overly common, as it takes a very specific load to fracture it, but I’d bet my left testicle that this is the cause of your pain. Heck, I’ll throw in both nuts. You could start with another set of plain films looking at the Hook of the Hamate, and, if that doesn’t shed any light on the issue, I would graduate to an MRI. CT scans are more sensitive to bone fractures, but an MRI should be sufficient and has the added benefit of supplying information about ligament or cartilage damage. That said, I doubt the cause of your pain is soft-tissue damage, as it seems far more acute under mild pressure than I would expect from anything other than grinding two fractured bone ends together.

    If this is the case, I suspect you will have it immobilized for four to six weeks to see if the fracture heals; usually it does. Given the amount of time that has passed, however, you are at a higher risk of non-union (the bone ends do not rejoin) and necrosis (the fragment dies) of the hook component beyond the fracture line.

    Non-union or necrosis usually result in surgery to either remove the fragment if it is small or, if the fragment is large enough and still healthy, to install internal fixtures to stabilize the bone ends in the hope that they will then bond.

    Any way you look at it, you have a good prognosis and should return to climbing without any residual impact. Over what course of time is largely dependent on how it plays out diagnostically.

    This article was published in Rock and Ice 225 (April 2015).

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