Hypothenar Hammer Syndrome

Aka: Hypothenar Hammer Syndrome

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II. Mechanism

  1. Occlusion of ulnar artery at the wrist
    1. Secondary to thrombosis of ulnar artery
  2. Due to repetitive Trauma to ulnar hand
    1. Example: hand is used as a hammer

III. Symptoms

  1. Hypothenar pain and pallor
  2. Hypothenar Paresthesias
  3. Affected digits are cool

IV. Signs

  1. Localized tenderness at hypothenar prominence
  2. Abnormal Allen Test

V. Imaging

  1. Wrist XRay with Carpal Tunnel view
    1. Assess for Carpal BoneFracture (esp. pisiform Fracture, hook of hamate Fracture)

VI. Differential Diagnosis

  1. Ulnar Tunnel Syndrome
  2. Carpal Bone Fracture at ulnar aspect (associated with Ulnar Nerve injury)
    1. Pisiform Fracture
    2. Hook of Hamate Fracture

VII. Management

  1. Eliminate precipitating factors
  2. Surgical resection of thrombosed section of vessel
    1. Indicated for persistent symptoms

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