The Gasp Heard Round Kane County

Kane County with a collective D'oh...
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

3- CT Scan of fractured hamate, front/side CT views

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.

D'Oh!

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Comments

Love the video slide show, esp. the "Orthopaedic Humor" bit at the end, which was kind of lame -- but, hey, they tried. It did allow me to visualize the "hook" fracture well, as you described it. I really appreciate your primer on this injury (and the others you've done in the past).

here is a less lame attempt at orthopedic humor...

"There is a fracture, I need to fix it"

http://www.youtube.com/watch?v=q0S5EN7-RtI

"The patient is well except for a condition I have not seen before...Asystole."

Not lame -- pretty dang funny.

I know every injury is different, but Cubs minor league 3B Dustin Geiger suffered a broken hamate bone taking BP the last day of Minor League Camp last year (April 1st), He then had surgery, and eventually returned to game action at Extended Spring Training on May 19th (about seven weeks later) and then moved-up to Peoria in June.

Geiger initially struggled (hitting 227/261/318 with two doubles in seven games at EXST), but then he hit 251/301/465 with 17 HR in only 75 games for Peoria over the second half of the season. and Geiger is not the prospect that Almora is. 

So Almora could very well return to game action at Extended Spring Training as early as the first week of May, and then perhaps move up to Kane County when EXST concludes the first week of June (if not earlier).   

Trey Martin should be the starting CF at Kane County the first couple of months of the season, and while he's not Albert Almora, he is a pretty good prospect in his own right.  

Hope he's fine, looking forward to going to Kane County to see him, Baez and Soler.

Baez and Soler will probably be in Daytona though yeah?

DUSTY B: Both Baez and Soler will be at Daytona, and Pierce Johnson, Juan Carlos Paniagua, Ben Wells, Dan Vogelbach and Reggie Golden could very well be there, too. 


It looks like the Daytona Cubs will be the "crown jewel" affiliate, at least at the start of the season.

Paniagua ia accounted for, then? I was worried he'd be in some border-town hotel until July awaiting permission to cross.

TIM: I am presuming Paniagua will be acounted for eventually.

well shoot.

MiLB Transactions is listing Starling Peralta being assigned to the Iowa Cubs. The D-Backs must have sent him back to the Cubs.

...and yesterday Barret Loux was assigned to the minor league camp

HAGSAG: Yes. The Cubs reclaimed Starling Peralta after waivers were secured, so the Cubs got $50,000 from AZ when Peralta was drafted, and returned half of that ($25,000) to the D'backs when they reclaimed Peralta.  


Per MLB Rules, Peralta technically had to be sent outright to the reserve list of the minor league club from which he was drafted (AAA Iowa), even though he will almost certainly be assigned to  the Tennessee or Daytona squad at Minor League Camp,


Peralta wil probably be a rotation starter at Daytona in 2013, and he will be eligible for selection in the 2013 Rule 5 Draft if he is not added to an MLB 40-man roster by 11/20, 

here is the cubs.com link to current transactions through 3/14...

http://chicago.cubs.mlb.com/team/transactions.jsp?...

televised cubs baseball on WGN...woo!

Hawk doing the game....boo!

the announce crew seems to be totally ignoring any cubs action happening on the field...continuing interviews and talking while play is going on...not even acknowledging it...such as the brad nelson double that just happened without even a mention...or the fielding error that led to valbuena reaching 1st and nelson moving to 3rd...

they seem to be too lazy to actually look at the numbers on the back of the jerseys and put a name to them...

Well Feldman is in mid-season form...guh.

look on the bright side...i bet he can at least half his current 10.00+ ERA once the season gets rolling.

woo, improvement.

this is the only signing of the off-season that weirded me out. some i thought were "meh" or unnecessary, but i still don't get the feldman signing.

this game keeps sucking by the minute...grand slam viciedo (off rondon).

1-9 chc/wsox, bottom 4...

feldman - 3.2ip 7h 2bb 2k 7er (11.81 total ST ERA)

holy crap...

i finally get to see z.rosscup...and he loads the bases with 0 outs on 3 straight walks. mega-fail.

john "who dat" andreoli 2r HR top 9th...looks like a minor league bench filling invitee to the game today...

WSOX win 15-3.

hj lee + r.chirinos optioned to AAA (TB) to join c.archer...b.guyer might break with the club, he's 27, not much left to show in AAA.

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