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12/18/07 THE KIDS CALL HIM ZIM!!! The Hamate BONE!!! Or The Hook-Bone!!

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     I was watching the Washington Capitals this weekend...Yes I was watching the Washington Capitals this weekend when I saw a familiar face on the TV screen...

     THE KIDS CALL HIM ZIM!! Ryan Zimmerman was being interviewed in one of those, "Look Who's At the Game"-type segments along with a Washington Redskins player I'm afraid I didn't recognize, but what I did notice was the splint/cast on Zimmerman's left wrist? Or was it a new type of t-shirt-cuff? Which got me wondering about Ryan Zimmerman's left hand/wrist...

     mlb.com's Bill Ladson first shocked Nationals fans with the news back on November, 8, when he presented the story in an article entitled, "Zimmerman has wrist surgery", at the Nationals' official site, in which Mr. Ladson reported that the injury, which occured while Zimmerman was taking batting practice, had required surgery, which had been successfully performed, to repair a broken bone in the twenty-two year old third baseman's left hand.

     The prognosis...A week in a splint, rehab, recovery in 4 to 6 weeks. The broken bone in question was the hamate bone...

     According to wikipedia, the free online encyclopedia, the hamate, or unciform bone is a wedge shaped bone in the hand. Quoting wikipedia.org the etymology of the word hamate, "...derives from the Latin hamatus "hooked," from hamus which means "hook." The hamate bone is a carpal bone," according to my dictionary, "...situated on the lower outside edge of the hand. It has a hook-shaped projection on the palmar side to which the muscles of the little finger are attached."

     According to "emedicine.com from webmd.com" and an article entitled, "Hamate Fracture", by Amy Powell, MD, Assistant Clinical Professor, Department of Orthopedics, University of Utah, there are two types of hamate fracture, one involving the body of the bone, the other involving the "hook" of the bone, both of which are rare, but most often occur in those who participate in sports involving "raquets, bats or clubs."

     Dr. Powell writes in the article that:

          "...most patients with this injury seek medical advice only
          after persistent symptoms, they often present weeks to
          months after the initial injury."

     In an article by Rich Campbell at fredericksburg.com, published by The Free Lance-Star, entitled, "Zimmerman undergoes surgery on broken wrist", on November 9, 2007, Mr. Campbell writes:

          "Zimmerman said that the injury was caused by 'wear and
          tear' and that he had experienced minor, nagging wrist
          pain for several years. He expects to be fully healthy in
          four to six weeks, and his normal offseason routine
          should not be dramatically affected."

     Then...five days later...It's Bill Ladson again, back at washington.nationals.mlb.com with another article, "Zimmerman has second wrist surgery", in which Mr. Ladson reports that, "...after feeling numbness on the tips of his fingers and noticing significant swelling on the hand," Ryan Zimmerman was forced to undergo a second procedure to relieve the pressure a hematoma was causing.

      In the last paragraph of the article, Mr. Ladson writes:

           "Zimmerman said he started having wrist problems in
           2005, when he was playing in the Arizona Fall League. He
           said that he left the league a few weeks early because of  
           the wrist. Zimmerman continued to have some
           discomfort in the wrist during the next two years, but it
           wasn't enough to make him miss games."

     So apparently Zimmerman held out longer than most patients would, according to Dr. Powell's article. The idea of Zimmerman playing two seasons with a fractured bone in his hand is kind of amazing to me...did he never report the discomfort? Did no one x-ray his hand/wrist if Zimmerman did complain? 90 doubles, and 44 HR's on a broken hand?...

     But...Dr. Powell, Bill Ladson and wikipedia.org assure me that this is a common injury amongst baseball players. In Dr. Powell's article, it's noted that there are two types of surgical procedures to repair a fractured hamate, "One involves excision of the hook itself. The other is an open reduction and internal fixation (ORIF) procedure."

     Ryan Zimmerman had the bone fragment excised, according to Bill Ladson's article, and Dr. Powell's article suggests that though there are worries of decreased grip strength associated with the excision of the fractured bone, clinical studies have shown no significant difference between patients who have undergone either the (ORIF) or the alternate excision.

      Recovery time is 3-4 months according to Dr. Powell's article, and that's without factoring in Zimmerman's second surgery, but all of the recovery-time projections fall in line with Ryan Zimmerman being ready for Spring Training and his fourth Major League season in DC...

     I'm not really sure if knowing all about the fractured hamate makes me feel better or worse...

*Zimmerman's Wrist Links*

mlb.com's Bill Ladson's article at washington.nationals.mlb.com entitled, "Zimmerman has wrist surgery":

http://washington.nationals.mlb.com/news/article.jsp?ymd=20071108&content_id=2295775&vkey=ne ws_was&fext=.jsp&c_id=was

wikipedia.org page on the hamate bone:

http://en.wikipedia.org/wiki/Hamate

Author Amy Powell, MD, Assistant Clinical Professor, Department of Orthopedics, at the University of Utah's article entitled, "Hamate Fracture" at emedicine.com:

http://www.emedicine.com/sports/topic44.htm

fredericksburg.com's Rich Campbell's article, "Zimmerman undergoes surgery on broken wrist":

http://www.fredericksburg.com/News/FLS/2007/112007/11092007/332147

mlb.com's Bill Ladson's article at washington.nationals.mlb.com entitled, "Zimmerman has second wrist surgery":

http://washington.nationals.mlb.com/news/article.jsp?ymd=20071113&content_id=2299932&vkey=ne ws_was&fext=.jsp&c_id=was