Articles

Golf Injuries

Seasonal Sports: Golf

By Dr. Randall Culp, MD
Reprinted here from the Summer/Fall 1997 "First Hand News"

With the increasing availability and popularity of golf, there has been a similar increase in golf-related injuries. As a sport, golf requires considerable skill and practice. Injuries often result from a combination of factors including age of participants, poor technique and overuse. Wrist injuries are the most common sustained by golfers. One increasingly common injury is the fracture of the hook of the hamate bone of the wrist. It is a diagnosis which is commonly missed by physicians unaware of its existence.

Hook of the hamate fractures usually occur when the club strikes hard ground or hidden objects during the golf swing. Force is transmitted to the gripping hand (the left hand for a right handed golfer), and fractures the hook of the hamate, which lies adjacent to the club handle in the palm. This causes pain along the little finger side of the wrist and palm.

Because the fracture is commonly missed on plain x-rays, a qualified specialist is necessary to order the appropriate special x-rays and studies to confirm the diagnosis.

If diagnosed early, the fracture can be treated with a cast. Usually, however, the fracture is missed until later, when surgical excision of the unstable hook of hamate fragment is often effective for pain relief. Another wrist injury common among golfers is a tear of a special ligament called the triangular fibrocartilage, which is located on the little finger side of the wrist. Injury usually occurs after the club strikes hard ground or deep sand, or after overuse during practice sessions. The usual symptoms are pain and swelling in the little finger side of the wrist. A painful click with rotation of the forearm is another common complaint.

Once again, x-rays often fail to reveal this injury. A correct diagnosis often requires special testing, such as an MRI.

Initial treatment focuses on splinting, rest and anti-inflammatory medications. A cortisone injection is occasionally helpful.

Patients who do not respond to conservative treatment may require a specialist in order to discuss newer surgical procedures to treat a tear of the triangular fibrocartilage. Fortunately, minimally invasive arthroscopic techniques are often successful in treating this injury.