From the Research
Hypothenar hammer syndrome is caused by repetitive trauma to the ulnar artery as it passes through the hypothenar region of the hand, leading to vessel wall injury, thrombus formation, aneurysm development, or vessel occlusion, as supported by the most recent study 1. This condition typically occurs when people use the heel of their hand as a hammer to strike objects, tools, or surfaces repeatedly over time. The repetitive impact damages the ulnar artery where it passes over the hamate bone, leading to vascular damage that manifests as pain, numbness, cold sensitivity, and sometimes color changes in the affected fingers.
Key Points
- Common occupations at risk include mechanics, carpenters, metal workers, and factory workers who frequently use their palm as a striking tool, as noted in 2.
- Sports activities like martial arts, mountain biking, baseball, and volleyball can also contribute to this condition due to repetitive hand trauma, as mentioned in 3.
- The anatomy of the hypothenar region makes it particularly vulnerable because the ulnar artery is relatively exposed as it courses over the hook of the hamate bone, with minimal protective tissue between the artery and external forces, as described in 4.
- When the heel of the hand is used to strike objects, the force compresses the artery against this bony prominence, eventually causing vascular damage, as explained in 5.
Diagnosis and Treatment
- Definitive evaluation is made with catheter-directed angiography, which remains the gold standard for diagnosis, as stated in 1.
- The range of management options depends on the degree of severity and the presence or absence of ulnar artery aneurysm, as discussed in 2.
- Surgical treatment, by resection of the involved arterial segment and revascularization either by direct anastomosis or by means of a venous interpositional graft, is recommended in some cases, as suggested in 5.