Golf swing could cause tiny fracture in hand

Q. About six months ago I was golfing and hit the ground hard and hurt my right hand. It was sore but I was able to keep golfing. Since then, whenever I swing hard my right hand still hurts. I saw my primary doctor, who took X-rays. He did not see anything broken and gave me an anti-inflammatory medicine. I took Ibuprofen for a couple of weeks but it did not really help. Although I am still able to play, the injury has significantly affected my golf game and I wondered what else it could be and what I should do.

A. An injury that occurs in golfers and baseball players is an injury to the hook of the hamate bone in the hand. This occurs when striking the ground or the bat in an awkward manner. The result? Fracturing a tiny bone in the mid-part of the hand just below the wrist.

Routine X-rays usually do not show this fracture and the physician needs to suspect this unusual injury in order to be able to diagnose it. I recommend that you see an orthopedic surgeon or hand specialist for evaluation and treatment. A special X-ray view known as a carpal tunnel view may show this unusual fracture. Occasionally an MRI scan or CAT scan may be necessary to confirm the diagnosis and help plan your treatment options. It is also possible that you may have injured a different bone in your hand or injured a tendon. If a hook of the hamate fracture is found, however, many times surgery is required to correct the problem. However, the success rate is usually quite high and a return to golf relatively quick. Good luck.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to