Carpal Tunnel Release as a Potential Risk Factor for Hook of Hamate Fracture: A Case Report

Case A 65-year-old right-hand dominant female presented with right-sided wrist pain after a fall one month prior. She had a history of left-sided carpal tunnel syndrome (CTS) treated with carpal tunnel release (CTR) and 9-tendon synovectomy one year earlier. Four weeks after a right-sided CTR, she sustained a right-sided hook of hamate fracture (HHF). Physical examination revealed tenderness over the hamate and pain with resisted flexion of the small and ring fingers. Radiographs confirmed a nondisplaced HHF, and CT imaging showed an acute/subacute fracture with cystic changes. Initially managed non-surgically, follow-up imaging revealed a nonunion, and she underwent surgical excision. Postoperatively, her pain significantly improved, with mild dysesthesia in the small finger. Conclusion This case suggests a potential link between CTR and subsequent HHF, possibly due to altered biomechanical forces. This observation highlights the need for further research on the long-term impact of CTR on carpal bone stability and fracture risk.