Hooked on Non-union: A Rare Case of Concurrent Scaphoid and Hook of Hamate Non-union

Carpal fractures are common orthopaedic injuries, with the scaphoid being the most frequently affected bone. Hamate fractures are uncommon and easily missed due to their subtle clinical presentation and difficulty in detection on standard radiographs, often being misdiagnosed as soft tissue trauma. Simultaneous involvement of the scaphoid and hamate is uncommon, and progression to dual non-union is even more so. We report a case of concurrent scaphoid and hook of hamate non-union to highlight the importance of early recognition and appropriate imaging to prevent delayed diagnosis and long-term complications. A 31-year-old male presented with a painful wrist and tender anatomical snuffbox following a fall. Radiographs confirmed a scaphoid fracture, treated nonoperatively in a cast. Symptoms persisted after eight weeks; thus, a CT was performed, confirming a suspected scaphoid non-union and a hook of hamate non-union fracture. Management involved fixation of the scaphoid fracture and excision of the hook of hamate, with the patient pain-free and at baseline mobility at four months.