Fact-sheet: Hypothenar Hammer syndrome
  • Hypothenar hammer syndrome


Updated on 03/30/2022 at 5:38 PM

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Definition

Hypothenar Hammer syndrome is a vascular acrosyndrome of the upper limb secondary to repeated microtrauma of the ulnar artery, resulting in:

  • Dissection
  • Stenosis
  • Thrombosis
  • Pseudoaneurysm
  • Distal thromboembolism

Clinical features

  • Cold sensation and pain in the palm
  • Raynaud syndrome
  • Tender hypothenar eminence
  • Ischemia of the fourth and fifth fingers (usually)
  • Positive Tinel sign on compression of the ulnar nerve
  • Positive Allen test

CT

Perfusion CT, complete analysis of the following associated features:

  • Irregular "corkscrew" or "beaded" appearance of the distal ulnar artery
  • Pseudoaneurysm of the distal ulnar artery
  • Occlusion of the segment of the ulnar artery overlying the hook of the hamate
  • Distal digital arteries that are occluded or show delayed opacification

Vascular intervention

Arteriography: Similar findings to perfusion CT, but only depicts the vessels