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Hypothenar Hammer Syndrome: Case Reports and Brief Review

C. Timothy Ablett, MD, MPH, Occupational Health, Marshfield Clinic, 1000 North Oak Avenue, Marshfield, Wisconsin 54449
Laurel A. Hackett, FNP, COHN-S, Occupational Health, Marshfield Clinic, 1000 North Oak Avenue, Marshfield, Wisconsin 54449

Reprint Requests: C. Timothy Ablett, MD, MPH Occupational Health Marshfield Clinic 1000 North Oak Avenue Marshfield, WI 54449 Tel: 715-221-7008 Fax: 715-389-3808 Email: ablett.charles{at}marshfieldclinic.org

Patients with hand and finger pain regularly present to primary care practices. Although a well-known clinical entity to specialists, hypothenar hammer syndrome is an uncommon vascular overuse syndrome that may not be familiar to primary care practices. It is caused by trauma to the palmar portion of the ulnar artery, usually as a result of occupational or sports activities which involve repetitively striking objects with the heel of the hand. In this report we describe two representative cases as well as discuss clinical features, pathogenesis, diagnosis, imaging and management.

Key Words: Allen text • Digital ischemia • Hand injuries • Hypothenar hammer syndrome • Occupational • Repetitive hypothenar trauma • Ulnar artery occlusion