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Hypothenar Hammer Syndrome

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Other Names

  • Ulnar Hammer Syndrome

Background

  • Uncommon problem
  • Most commonly seen with hypothenar eminence trauma by repetitively using the hands as a hammer

Pathophysiology

  • Symptom complex attributable to an ulnar artery aneurysm
  • Athletes who use their hand for catching and striking objects
  • Manual laborers whose hands are subjected to repetitive trauma
  • The superficial palmar branch of the ulnar artery can develop intimal damage producing vasospasm and encouraging platelet aggregation and thrombus formation.
  • If the damage spreads through the media into the arterial wall, aneurysm formation can occur as well. The periadventitial tissues can become involved, leading to extrinsic scarring, vascular narrowing and thrombosis.
  • Microemboli can be generated that can occlude the digital arteries downstream, resulting in digital ischemia.

Risk Factors

  • Male
  • Occupations
    • Metal workers
    • Auto mechanics
    • Lathe operators
    • Machinists
    • Miners
    • Sawmill workers
    • Butchers
    • Bakers
    • Brick layers
    • Carpenters
  • Sports
    • Baseball
    • Karate
    • Golf
    • Softball
    • Hockey

Differential Diagnosis

Potential vascular etiologies include

Potential neurogenic causes include


Clinical Features

  • Related to the degree of vascular insufficiency
    • Most common: Finger discoloration or pain
    • Ulceration
    • Cold intolerance
    • Numbness
    • Coolness
    • Cyanosis
    • Paresthesia
    • Hypothenar mass

Evaluation

Radiographs

Angiography

  • Gold standard
  • Diagnosis and helps plan surgical management

CTA


Classification


Management


Complications


See Also


References

Created by:
John Kiel on 14 June 2019 09:02:28
Authors:
Last edited:
13 October 2022 21:57:13
Categories: