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Thrombosis
of the ulnar artery in the hand is the
most common type of upper extremity
vascular occlusion. It is commonly
known as hypothenar hammer syndrome
because it is often the result of a
constant pounding on the ulnar side of
the palm of the hand such as might be
associated with roofing workers.
Multiple symptoms can result, including
and not limited to pain, numbness and
tingling, weakness of grip,
discoloration of the fingers and even
ulcers of the finger tips.
 This
patient presented with a history of
pain, numbness and tingling and a
painful lesion on the tip of his long
finger. He often used his palm as
a hammer to pound objects into position
at his work.
 An
arteriogram of his right hand was
performed and revealed poor flow in the
ulnar artery at the level of the hamate
and pisiform bone.
 A
surgical exploration was
performed. In this intraoperative
figure the ulnar artery has been
dissected free and can be seen to be
clotted. The clot extends to a
common digital artery supplying the long
finger.
  At
four weeks after surgery the patients
ulcer has healed and he is pain
free. There is excellent flexion
and extension of all the fingers.
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