Hamate injury shouldn't toss a hook at career of Phillies prospect Dom Brown

Domonic Brown is not the first Phillies player to be hindered by a hamate injury. (Yong Kim/Staff Photographer)
Domonic Brown is not the first Phillies player to be hindered by a hamate injury. (Yong Kim/Staff Photographer) (Jonathan Tannenwald)
Posted: March 07, 2011

CLEARWATER, Fla. - Hook of Hamate . . .

It has the same sinister ring as Horn of Africa. Straits of Hormuz. Golan Heights.

Read any of them in print and bad news is sure to follow. This breaking news just in:

Civil war is the typical Horn of Africa deal involving Sudan, Ethiopia and Somalia.

Iran controls the entrance to the Straits of Hormuz, which surrounds the entrance to the Persian Gulf.

Syria looks down into Israel from the Golan Heights.

Hook of Hamate? What part of Africa is that in?

First time I heard the medical term for a tiny bone that is the appendix of the hand, Dave Hollins had fractured one of his. Then he fractured the other.

"I believe Dave Hollins played 3 or 4 years after he had his hamate problem," GM Ruben Amaro was saying yesterday after Domonic Brown's fractured H of H ended his spring training Saturday with a probable excision tomorrow by hand specialist Dr. Randall Culp.

Culp is as good as it gets in his field. Mean old Mr. Hamate is in big trouble when Randall takes him on.

Ruben, who was a Hollins teammate, is absolutely right. And in 1993, when the Phillies won the pennant, the former Rule 5 third baseman was a major force in the National League's most prolific offense. The year before, Dave slammed 27 homers and drove in 93 runs for a last-place team.

The intense infielder with the burr cut and sometimes-scary intensity started having some hand problems in '93. But he still managed another big year, hitting 30 doubles, 18 homers, driving in 93 runs again and scoring 104.

Despite surgeries on both H of Hs, Dave kept on keeping on. Ruben is correct. He did have some productive seasons while playing for six - count 'em, six - American League teams. Dave returned to the Phillies in 2001, but it wasn't the H of Hs that finally betrayed him. He was bitten that spring training by a brown recluse spider and the effects of the venom compromised his battle with life-long juvenile diabetes.

Dave is a major league scout for the Phillies now and he didn't need Saturday's latest troubling Dom Brown development to call attention to his own battles.

So where is this Hook of the Hamate? Make a fist and locate the knuckles of the fourth and fifth fingers. Slide a finger about a half inch down from the knuckles. There it is. Not very much, is it?

But besides the pain involved, a fracture of the small, connective bone can produce instability in the fourth and fifth fingers. It also shields the carpal tunnel, which leads to the ulna.

Injuries to hamates, while relatively rare, seem to be most common to baseball, golf and tennis players and typically begin with a hairline fracture that causes some discomfort but doesn't prevent full range of hand motion.

I was remarking to a photographer during Dom's first at-bat Saturday against the Pirates at Bright House Field that the slump-ridden outfielder had dramatically widened his stance. I thought he was set up the best I had seen him during an exhibition season of almost daily adjustments. Dom swung at the first pitch and fouled it back. He showed no signs of distress, but later told athletic trainer Mark Anderson and Amaro that he suffered the injury on that swing. He worked a full count and bounced a base hit up the middle off Bucs lefthander Paul Maholm for his first hit of his silent spring.

Small as the bone is, it is not a trifling injury . . .

I have been fortunate in recent years to have an MD weigh in with his opinion - not prognosis or diagnosis - of some key Phillies injuries, from Pat Burrell's wrist to Chase Utley's various miseries. For privacy and confidentiality reasons, I can't identify him, but the doctor rarely paints a worst-case scenario. This is no exception. I asked him by e-mail if this could be another drawn-out Dave Hollins problem in the making?

"In one sentence, it is high risk for non-union," he replied, meaning the process where the adjacent bones reattach themselves during the healing process following removal of the hamate. "That said, we always remember the worst case of everything, Hollins. MOST folks should do BETTER than Hollins and be up and around in due course . . . "

Due course with excision is 4 to 6 weeks, assuming no setbacks. And that is resumption of full activity. The doctor linked me to some medical-journal reading on the hamate procedure Brown is most likely to undergo.

"Complications that may arise from hamate excision include decreased grip strength,'" according to medscape.com. What followed was a little too clinical for laymen, including me, but the overall conclusion seemed to be that while there are risks that the hand may lose some strength, the excision procedure is the current gold standard.

There is no way of knowing, of course, if this is something Dom Brown has been fighting, just as Hollins fought it when he probably suffered a hairline fracture before the whole hamate went south on him. No way, unless the athlete fesses up. I personally saw nothing to indicate his swing was being inhibited by pain in his bottom right hand.

Spring Training 2011 is going to go down in the career of a kid who has been ranked baseball's No. 1 prospect and is currently No. 4 as a time when if he didn't have bad luck, he would have had no luck at all.

Hopefully, there will be no Domonic Brown recluse spiders in his future.

Send e-mail to bill1chair@aol.com.

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