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Hypothenar hammer syndrome

An uncommon cause of secondary syndrome and digital ischemia

Finke-Fyffe, Sarah MSBS, PA-C; Regan, Jeanne RVT; Golan, John MD

Journal of the American Academy of PAs: September 2019 - Volume 32 - Issue 9 - p 33–35
doi: 10.1097/01.JAA.0000578972.17680.39
Case Report

ABSTRACT Hypothenar hammer syndrome affects less than 1% of the population, but if the diagnosis is delayed, digital gangrene and critical ischemia can ensue. The condition is caused by injury to the ulnar artery at the level of the hook of hamate when the palm of the hand is repetitively used as a hammer. Injury includes segmental occlusion of the ulnar artery and aneurysmal formation with or without occlusion. Patients with hypothenar hammer syndrome often present with symptoms of secondary Raynaud syndrome; if Raynaud is unilateral, a vascular origin should be suspected and ruled out. Treatment options for hypothenar hammer syndrome include conservative treatment measures, fibrinolysis, or surgical resection and repair, and depend on the specific injury and timing of diagnosis.

At the time this article was written, Sarah Finke-Fyffe practiced at North Shore Vascular Associates in Northfield, Ill. She now practices at Ohio State University's Wexner Medical Center in Columbus, Ohio. At North Shore Vascular Associates, Jeanne Regan is a registered vascular technologist and John Golan is president and a vascular surgeon. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Copyright © 2019 American Academy of Physician Assistants
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