Hypothenar hammer syndrome: case reports and brief review

Abstract

Patients with hand and finger pain regularly present to primary care practices. Although a well-known clinical entity to specialists, hypothenar hammer syndrome is an uncommon vascular overuse syndrome that may not be familiar to primary care practices. It is caused by trauma to the palmar portion of the ulnar artery, usually as a result of occupational or sports activities which involve repetitively striking objects with the heel of the hand. In this report we describe two representative cases as well as discuss clinical features, pathogenesis, diagnosis, imaging and management.

Figure 1.

Upper extremity arteriogram showing normal radial artery (dark arrow) and interosseous artery (open arrow). The ulnar artery demonstrates delayed filling (white arrow) compared with the others, suggesting distal stenosis or occlusion.

Figure 2.

Upper extremity arteriogram showing ulnar artery occlusion (white arrow).