Stress Fractures

Stress fractures are small cracks in bone caused by repetitive loading rather than a single traumatic event. In the upper extremity, they are most common in the hook of the hamate, the distal radius, and the ulna, and are frequently seen in athletes who perform repetitive gripping, swinging, or throwing activities.

Common Upper Extremity Stress Fractures

Hook of hamate stress fractures are classic in golfers, baseball players, and racquet sport athletes — the grip of the club or bat repeatedly impacts the hook of the hamate. Patients present with ulnar-sided palm pain that is often missed on standard X-rays.

Distal radius stress fractures occur in gymnasts from repetitive weight-bearing through the wrist. Ulnar stress fractures are seen in throwing athletes and tennis players. Early diagnosis is critical to prevent complete fracture displacement.

Treatment

Most stress fractures of the distal radius and ulna respond to activity modification and immobilization with casting or splinting for 4–8 weeks, followed by a gradual return to sport.

Hook of hamate fractures have a poor healing rate with non-surgical treatment. Surgical excision of the fractured hook is the preferred treatment for athletes, providing reliable pain relief and rapid return to sport.

Common Symptoms

Gradual onset of activity-related pain
Tenderness over the fracture site
Pain that worsens with continued activity
Ulnar palm pain with gripping (hamate)
Wrist pain in gymnasts or throwing athletes
No clear traumatic event

Treatment Options

Activity modification and rest
Casting or splinting for 4–8 weeks
Hook of hamate excision for athletes
Gradual return-to-sport protocol
Technique and equipment modification
Nutritional and bone health optimization

Ready to Get Help?

Dr. Kinchelow specializes in treating stress fractures. Schedule a consultation today.

Request Appointment (954) 635-5300