Clinical outcomes of hook of hamate fractures and usefulness of the hook of hamate pull test.

We report the usefulness of hook of hamate pull test (HHPT), described by Wright et al. in 2010, along with therapeutic outcomes of hook of hamate fractures. Eleven patients (two with fresh fractures and nine with nonunion) were studied. The fractures were diagnosed with HHPT for recently encountered 4 patients and a definitive diagnosis was made by a carpal canal view and a computed tomography (CT) scan. Treatment involved cast immobilization for one fresh fracture case, and bone fragment removal immediately over the hook for ten others. HHPT was positive in all the four cases. Union was achieved by conservative treatment, and hypothenar pain disappeared after surgery. Patients returned to work/sports two months postoperatively. HHPT was useful for diagnosing both fresh fractures and nonunion. If HHPT is positive, CT should be performed even if the fracture is obscure on a carpal canal view.