As originally posted on The Cub Reporter
by Dr. Joseph Hecht
Kane County with a collective sigh.
Albert Almora tweets he sustained a broken hamate bone in the distal wrist today.
Not a good day! Broke my Hamate bone!
Sun-Times scribe Gordon Wittenmeyer writes that the injury occurred while swinging a bat and Almora will get surgery on this injury.
…he broke the hamate bone, presumably in his left hand. It’s a fairly common injury in hitters’ bottom hand. Almora broke the bone swinging a bat and will require minor surgery. The Cubs said he will need three-to-four weeks before resuming baseball activity. Almora is projected to open the season at Class A Kane County, and he’ll begin on the disabled list. He should return to game action in late May.
The hamate is a small bone in the distal or 2nd row of wrist bones just below the 4th/5th metacarpal (ring and little finger side hand bones). The bone has an unusual shape with a hook configuration. The fracture occurs most commonly in the connection between the base of the bone and the hook. Conventional wrist X-Rays often do not show this fracture but a specific additional view that is tangential to the wrist (carpal canal view) will show the fracture. Thus, it can be easily missed if not seen by a physician who is familiar with this injury and requests this additional view. If it’s still in question, Computerized (CT) Imaging or MRI Imaging will confirm this fracture. Often hook of the hamate fractures do not heal with rest and immobilization and so it’s now common for athletes to get iinitial surgical treatment with excision of the hook fragment. Giants 3B Pablo (Big Panda) Sandoval, Rockie SS Troy Tulowitzki, Oriole OF Nick Markakis, Red Sox 2B Dustin Pedroia and Phillie OF Domonic Brown are recent players with hamate fractures and their stories are attached to the links I included. This injury is not nearly as serious as the distal radius wrist fracture that Derrek Lee sustained (back in 2006) because it’s more distal in the palm and not as likely to impact wrist movement. Hook of the hamate fractures create issues with grip tenderness such as holding a bat but usually does not diminish bat speed. So if all goes well, Albert Almora should be able to return to hitting activity in about 6 weeks.
There IS a lot written about hamate fractures in baseball players, so here are a few links to the anatomy, imaging and treatment..after the jump.
1- Recent abstract on Hamate fractures in baseball players (American Association for Hand Surgery).
2- Yahoo article on hamate fractures in baseball
4- Labeled diagram of all wrist bones including the hamate. The metacarpal bones are at the top of the image. The major wrist bones, the radius and ulna are below the carpal bones at the bottom of the image.
5- Video slide show wtih more information than needed (some of the Hamate fracture patterns presented here are quite rare) but it does contain some good diagrams and information.