Broken Hook of Hamate...

I've talked about my experience in a couple of other threads but I still thought I would share the crap that I have had to put up with since last August.

While playing one of the better rounds of golf last year my left hand started to feel a bit sore. I went on to shoot a 75 but I noticed that I was rubbing the palm of my left a hand a lot during the back nine. I took a couple of days off afterwards then started practicing and it was still sore/painful. I played again the next weekend and it went horribly. I was sore/weak on almost every single shot but scrapped the ball around and shot 89. Went to the doctor and they took and x-ray and it showed nothing. I was told to rest it for a week. I listened to the advice but the following week my family went to Hilton Head. I tried to play and was yelling in pain after some of the shots because of the pain. My dad was telling me to shut up because he thought I was complaining about my poor ball striking. Jeez!

So I got in to see Othopedic specialist and he ordered and MRI. The MRI showed a small fracture in my hamate bone but he thought it was in the body of the bone and not the hook. He said this was very uncommon but that it should heal on it's own in 2-4 weeks. I waited three weeks and tried to hit some balls at the range. The result was pure pain. He the passed me on to an Otho. Hand Specialist who immediately put me in a cast for five weeks. This was absolutely horrible as you can imagine. When the cast came off she oredered a CT Scan and proclaimed that the bone was fine. She then said I could ease myself back into my rountine and start playing golf again whenever I was comfortable, but that I should expect some soreness. I definitely took my time. I started chipping and then pitching and then full swing. My cast came off the day before Thanksgiving and the first round I played was on New Year's Day. For my first round I though I played alright but there was some definite pain. The front nine went great but on the back nine I absolutely fell apart and shot 38-52. My hand hurt for nine days afterwards. This didn't seem completey normal but I knew to expect some soreness so I tried again after it felt better and it hurt like hell again. I go back to my hand specialist and she orders another MRI which comes back "clean." She seems perplexed and says that I should try physical therapy twice a week for five weeks to strengthen the hand. I go twice and realize it isn't doing anything.

I finally seek out another Ortho Hand Specialist and boy am I glad I did. He was able to pinpoint my pain right away and while looking at my MRI films that I brought along he thought that the bone still looked damaged even though the other doctor said it was fine. He ordered one more CT Scan and said that it came back showing that I have a fracture at the base of my Hook of Hamate. He then says that he needs to perform surgery to remove the piece of bone that is not healing. He actually said that in his 20 years of experience he has never seen this bone heal on it's own and that it always needs to be removed. I'm pissed that I was seeing the other doctor for so long because I have wasted so much time.

Surgery is scheduled for this Wednesday. He says that there is a chance I could be back to golf in 6-10 weeks but that 50% of his golfing patients complain of severe weakness and distance loss for 3-6 months after the surgery. I have read a couple of threads whene guys talked about this surgery but I would love more details from others that have suffered from this. Were you hitting the ball a lot shorter afterwards? What will I have to deal with after the surgery? Did anyone need physical therapy after the surgery? What else should I know about the process of getting back to where I was last year. Thanks.

Wow. That's a very unfortunate story, but it looks like there's a good ending in the works.

Good luck....and I hope you're up and golfing again (Finally) pain free in no time.

[quote name='ColinMB' timestamp='1301929096' post='3116999']
Wow. That's a very unfortunate story, but it looks like there's a good ending in the works.

Good luck....and I hope you're up and golfing again (Finally) pain free in no time.
[/quote]


[b][size="4"][color="#0000ff"]Ditto[/color][/size][/b]

I'll be sure to post about the healing process and how quickly my game come back to shape.

i broke the hook of the hamate last year...made golf unplayable and very painful...could not swing...

i got home and got the mri and ended up having surgery on the hand...they removed the hook and all has been good since...

very pleased with the results of the surgery

[quote name='LongJohn6284' timestamp='1301938247' post='3117451']
i broke the hook of the hamate last year...made golf unplayable and very painful...could not swing...

i got home and got the mri and ended up having surgery on the hand...they removed the hook and all has been good since...

very pleased with the results of the surgery
[/quote]

How long were you on the shelf after the surgery. Anything crazy go into the rehabilitation process?

Did the Radiologist interpret the MRI and CT as essentially negative? If so, I'd call my attorney. 8 months is a long time to suffer through a very painful injury.
You were miss diagnosed by 3 or 4 different specialists. That's unacceptable.
I work in radiology ( CT and MRI Technologist ) The Radiologists are overwhelmed with images these days due to the new technology.
However, the new technology also makes it so much easier to see this type of injury due to the sub millimeter image thickness and the way we can reconstruct the images in different planes.
Also your MRI should have shown at least some bone edema where the FX was and also in the surrounding tissue.
Good luck with your recovery and may you be pain free soon.

My dad fractured the hook of his hamate bone probably 10 years ago. He was fortunate to be referred to a good orthopedist initially that recognized the problem right away. He had the surgery, & within a few weeks he was, for the most part back to normal. He recovered fully. You will be fine now that you have the correct diagnosis and are getting the surgery; just a shame that the other doctors didn't recognize it. Sorry about your injury; I know how frustrating it can be (though I have never been out for that many months straight). Best wishes for a speedy recovery.

Surgery was a couple of days ago. I'm in a soft cast for a week and then I can take it off and clean up a bit. The doctor injected me with some sort of numbing agent to help with the pain but it is weird because my pinky is still 50% numb 48 hours later. They said this could take a few days to fully go away. I will be sure to post some pictures of the wound and track my progress.

Adam, sorry to hear about your injury, but glad to hear you had surgery to get it fixed. I had the same injury in 2007 and went through a similar situation. I thought I sprained my wrist and was wearing a wrist brace and/or tape to ease the pain, but it didn't really work. After a few weeks I saw a specialist who took a set of x-rays which showed nothing. So I rested a couple of weeks thinking it would go away.....but it didn't. First shot on the range and I had the same shooting pain. Back to the doc, another set of x-rays, still nothing. After another few weeks he finally sent me for a constrast MRI that showed the broken hook of the hamate. In total I spent about 3-4 months dealing with it before I got the MRI and surgery.

I had surgery to remove the hook and clean up the rest of the bone and was back on the course within 5 weeks!!! I will suggest that you get a Bionic glove for your first couple of months back on the course because the added cushion in the palm will help with the minor discomfort.

Here I am a few years later and don't have a single issue with it. Hang in there...you'll be back out on the course soon!!

I've posted a pic of my hand a day or two after surgery. I joked with the doc that he "autographed" his work. (it's really the word "yes" so they knew which hand to cut).

Kevin

Thanks for responding TPariff. I really appreciate the story and the picture. So you actually got to see the incision a couple days after surgery? My doctor put a piece of plaster around the incision and wrapped it up. He told me I couldn't unwrap it for seven days. I also hear of doctors putting some patients in casts for weeks after surgery so I'm happy I didn't have to go through that. Did you do any physical therapy? Do you remember anything else you did to treat the area afterwards?

Also, when you got back on the course five weeks later, how long did it take for you to feel normal again? What kind of discomfort did you experience?

[quote name='adambommb29' timestamp='1302282432' post='3133070']
Thanks for responding TPariff. I really appreciate the story and the picture. So you actually got to see the incision a couple days after surgery? My doctor put a piece of plaster around the incision and wrapped it up. He told me I couldn't unwrap it for seven days. I also hear of doctors putting some patients in casts for weeks after surgery so I'm happy I didn't have to go through that. Did you do any physical therapy? Do you remember anything else you did to treat the area afterwards?

Also, when you got back on the course five weeks later, how long did it take for you to feel normal again? What kind of discomfort did you experience?
[/quote]

Yes, as I recall the surgery was Tuesday and this picture was taken Friday after my first checkup. I may have had a soft cast but it wasn't anything too restrictive. IIRC the stitches were removed the following Friday, so about 10 days after surgery.

He gave me some cream to put on the scar after the stitches were removed. That helped with the itching and resulted in there being virtually no scar today.

There was no real PT, maybe because everything went so well. He did some grip tests in one of the follow up visits, but nothing else. In fact, I was chipping and putting 3 weeks after surgery. My doc is a golfer so he knew how antsy I was to do something!!

I felt pretty normal the first time I hit a full shot, just a bit nervous. My doc is the one who recommended the Bionic glove to help with any discomfort in the palm. But I really had no issues. It was really night and day compared to the pain I had in those months when I didn't know it was broken and was trying to play through it.

I think you'll be just fine a few weeks from now. For me the worst part was the first 24 hours after surgery because I'm not a "medicator" and the oxi's he presribed put me on my arse!! I took 2 total of the 30 and was done with them. To be honest, after the first 24 hours I had virtually no pain or discomfort.

Good luck! You'll be back out there in a few weeks.

Kevin

Ouch......

 

 

 

Well, you've come this far; let the six months play out if you have to and use pitching/chipping to better impact and ball flight. Then you'll be ready to tear it up even better than before! Best of luck in your recovery.

Soft cast is coming off tonight. I'll update with pictures later.

Well i thought i would put it up here first. I just came out of the cast and immediately took a picture. Hard to tell in this picture but the palm near the incision is pretty swollen. Man does it feel weird.

Had the surgery about 15 years ago and took off a solid 4 months. No swings at all. Depending on your skill make sure you're careful trying to come back to quickly. The doc who did mine had the same operation on his own hand and said he came back too quickly and developed a lot of bad habits by becoming to right arm dominant in the swing.

Take the time off. Pain free for 15 years now and I don't regret taking the time off.

I'll try to keep updating this. I think it's a good resource for others that suffer the same injury to hear what people with similar problems have gone through.

It's not been 15 days since my surgery and eight days since I came out of my soft cast. I still have some swelling but it is continuing to go down. I had my follow-up with my doctor yesterday and he thought I was right on track. He contiuned to emphasize that he thought it would take 8-12 weeks before I was able to get out and play a round of golf again. I'm hoping that it's even less than that! He said it was up to me and that if I wanted to go start putting and do some light chipping that he didn't have a problem with it. He seemed to be against physical therapy and thought everything would work out through normal use. I do have a friend that is a physical therapist so I might ask her what she thinks. My pinky finger still feels a bit numb but he said that would go away with time. I see lots of stretching and massaging in my future.

I will continue to update.

[quote name='adambommb29' timestamp='1302651390' post='3147879']
Well i thought i would put it up here first. I just came out of the cast and immediately took a picture. Hard to tell in this picture but the palm near the incision is pretty swollen. Man does it feel weird.
[/quote]


holy coconut balls on wheels does that look and sound painful.

All the best for you sir!

It has now been three weeks since I had my surgery so I thought an update was needed.

I first went out and did some light chipping and putting seven days ago with no problem. It was fun to be outside at the range again. Four days ago I went again and had a good time. I actually went further back and was doing pitch shots in the 30-40 yard range. Everything felt great although my hand felt a bit weak in my follow-through. That afternoon I was a little sore and I felt more sore over the next couple of days.

The soreness has now worn off for the most part. My scar is healing nicely. I might try to put up an updated picture to show the progress. I do have a question though, especially for those of you who have had part of your hamate removed. Although my wound is healing well, I still have a bit of a "knot" or swelling underneath the scar. It almost feels like the bone is prodruding a bit...even though I know it's not. I asked the doctor about this last week and he passed it off as being normal. But I still worry a bit and would love to know what others have experienced. When someone writes that they were back on the golf course in five weeks I have trouble comprehending how I could do the same. The doctor did tell me that the healing process could be 8-12 weeks and that he had some patients that took as long as six months. I know it has only been three weeks thus far but I am really itching to get out and play.

Please share anything you remember from your own hamate issues. I will continue to update.

Take care man, just don't rush it, the prognosis does sound good once they get the right diagnosis. Sounds somewhat common with golf, really surprised your docs didn't look for this right away, it being a golf injury.

Hand and wrist injuries are such a b****. I have had off and on wrist pain for 20 years, one from an old sprain that for some reason about 7 years after I hurt it it started to flair up again. And I developed a metacarpal bossing on the back of my left wrist a few years ago, hurt like hell when I hit the ball, like somebody was hitting the back of my wrist with a hammer. Just took some time off, did physical therapy and such and it doesn't seem to hurt now, but it is just a noticeable bump on my wrist. Same thing David Toms had, and he had to have surgery.....

At 3 1/2 weeks I had a bit of a break-through when I went and did some chipping and putting yesterday. It was feeling great so I decided to hit ten balls or so. I hit about seven shots with my pitching wedge and I felt like it was flying around 100 yds and my hand felt pretty good. I hit a couple of shots with my eight iron and that went well too. Finally I wrapped it up with one seven iron and overall the hand held up. Today there is only some slight soreness but that is it. Very encouraging and I'm now hoping to be moving on to my longer irons later in the week and maybe woods sometime next week. I told my wife that I am now hoping to play a legitimate round of golf in four weeks. We'll see if I'm off my rocker or not.

I'm still dealing with what I believe to be scar tissue. Has anyone else had problems with scar tissue? What did you do to get rid of it? I'm thinking I might have to make a trip to see a physical therapist.

Adam,

I don't recall having any scar tissue or knots. I posted this earlier, but be sure to get a Bionic glove. There's padding on the palm that will protect the scar while you fully heal. I used one of these gloves for the first several months hitting full shots and playing.

It sounds like you're making good progress. Good luck!

Kevin

I had the surgery 3 weeks ago I putted yesterday it felt funny gripping the club any ideas when gripping will feel normal Thanks Barry

[quote name='bkoff' timestamp='1344506915' post='5435444']
I had the surgery 3 weeks ago I putted yesterday it felt funny gripping the club any ideas when gripping will feel normal Thanks Barry
[/quote]

I'm facing this same surgery. How long did the doc say you'd be out of action?

[quote name='DLiver' timestamp='1344513961' post='5435708']
[quote name='bkoff' timestamp='1344506915' post='5435444']
I had the surgery 3 weeks ago I putted yesterday it felt funny gripping the club any ideas when gripping will feel normal Thanks Barry
[/quote]

I'm facing this same surgery. How long did the doc say you'd be out of action?
[/quote] he said 4 to 6 weeks where are you having it done and how did you break it

[quote name='bkoff' timestamp='1344518771' post='5436152']
[quote name='DLiver' timestamp='1344513961' post='5435708']
[quote name='bkoff' timestamp='1344506915' post='5435444']
I had the surgery 3 weeks ago I putted yesterday it felt funny gripping the club any ideas when gripping will feel normal Thanks Barry
[/quote]

I'm facing this same surgery. How long did the doc say you'd be out of action?
[/quote] he said 4 to 6 weeks where are you having it done and how did you break it
[/quote]

Don't know and don't know.

I get an MRI to confirm it on Monday and we go from there.

hi, apologies but i am no a golfer but have fractured hamate and will be having surgery. i just have to decide when... i came off bicycle onto both hands. broke hamate in left and tore ligaments in right. im in full arm cast on right for next six weeks. and out of work. im thinking I'm useless as is why not get the other hand done noiw? rather than wait til one is fixed and then be off work with other. what i need to know is whether one can still use fingers immediately after surgery for eating or dressing etc? how many days until movement is okay even with dressing?

im a writer just need to be able to type with more than one finger...

thanks

[quote name='lulu57' timestamp='1344953447' post='5468880']
hi, apologies but i am no a golfer but have fractured hamate and will be having surgery. i just have to decide when... i came off bicycle onto both hands. broke hamate in left and tore ligaments in right. im in full arm cast on right for next six weeks. and out of work. im thinking I'm useless as is why not get the other hand done noiw? rather than wait til one is fixed and then be off work with other. what i need to know is whether one can still use fingers immediately after surgery for eating or dressing etc? how many days until movement is okay even with dressing?

im a writer just need to be able to type with more than one finger...

thanks
[/quote] will not have much use for 10 days i am at 4 weeks and I am almost back to normal

I'm a PT and Certified Hand Therapist (CHT) - you had lingering numbness and perceived weakness because of inflammation or aggravation of the ulnar nerve which runs right through the hook of the hamate. Maybe it was the delayed diagnosis and surgery and maybe it is just how it was fractured and what soft tissue was affected.

Guyon's Canal Syndrome is persistent ulnar nerve entrapment by the bridge ligament that closes the circle making the hook of the hamate into a tunnel essentially. If this feeling of weakness and any 4th or 5th digit numbness persists see a CHT. Easily alleviated with massage and carpal line mobilization/manipulation.

Most people get complete resolution of symptoms by post-op week 10 ... some just need a bit of therapy to eliminate adhesions.

golow(TM)