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Hypothenar hammer syndrome

Case contributed by Paul Leschke
Diagnosis almost certain

Presentation

Cyanosis left hand. Occupation - tradesman.

Patient Data

Age: 40 years
Gender: Male
dsa

Occlusion of distal left ulnar artery. Further filling defects in the 2nd and 3rd common palmar digital arteries and lateral proper digital arteries of the ring and middle fingers. Probable filling defect in deep palmar arch.

Case Discussion

Hypothenar hammer syndrome is caused by repetitive trauma to the ulnar artery against the hook of hamate. This is typically seen in men in their 40s whose occupation or recreation involves chronic repetitive trauma to the heel of the hand (e.g. carpenter, bricklayer, baker, as well as some sports). There may be aneurysm formation, occlusion or distal embolization. Patients may present with pain, claudication, paresthesia or blanching.

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