Hypothenar Hammer Syndrome Definition, Symptoms, Causes, Treatment


Hypothenar hammer syndrome is defined as thrombosis of the ulner artery at superficial Palmer arch. The superficial branch of Palmer's artery lies in the hook of hamate. Whenever injury occurs at superficial branch of Palmer's artery, it leads to insufficient vascular supply to the inner artery of hand. It can occur as a result of repetitive use of hand as a hammer. It is a rare syndrome and is under investigation. It commonly occurs in males at the age of 40 and in people who work with their hand.

Like people who are metal workers, minors, mechanics,  butchers, saw mill workers, machinist, brick layers, carpenters and Bakers. It can also occur in sports man because they have to use their hand in game. Sports include golf, martial arts, soft ball, biking, hockey and baseball. It is the main cause of Raynaud's syndrome. Hypothenar hammer syndrome can be confused with  hand arm vibration syndrome so diagnosis is necesaary. For diagnosis, Allen's test is performed. In Allen's test, patient is asked to sit and close his fist. Examiner press the ulnar artery, if on releasing pressure, the color of finger becomes normal then the test is negative. But if the color does not normalize then the test is positive.

Hypothenar Hammer Syndrome Definition, Symptoms, Causes, Treatment

Hypothenar Hammer Syndrome Symptoms


The symptoms of hypothenar hammer syndrome involve middle, index, ring and little finger. Pain occurs in all five fingers due to trauma in ulnar artery. Patient can feel his finger tips getting cold. Paraesthesia, claudication and blanching my occur as symptoms. These all are the digital symptoms. Tenderness and pulsatile mass may be present in hypothenar as a result of aneurysm. Discoloration of finger tips is the common sign. They turn white or purplish in color. Along with discoloration, the finger tips become cold due to inappropriate circulation.

Hypothenar Hammer Syndrome Causes


The possible causes of hypothenar hammer syndrome are:

  • Excessive use of hand as a hammer and continuous hitting to the heel of hand can cause hypothenar hammer syndrome.
  • Abnormality in arterial system I.e. incomplete development of superficial Palmer arch.
  • Thrombosis in the arteries may lead to trauma. This trauma is responsible for hypothenar hammer syndrome. As trauma cause arterial damage and aneurysm of the artery which leads to ischemia in digits of fingers.
  • Anomality in hypothenar muscle can lead to hypothenar hammer syndrome.
  • External trauma or injury can also cause hypothenar hammer syndrome.

Hypothenar Hammer Syndrome Treatment


The treatment of hypothenar hammer syndrome consist of two strategiess i.e. medical treatment and surgical treatment. In medical treatment, medications are used to make blood thin and remove thrombosis. Medications used are vasodilators, calcium channel blockers, pentoxyphyline, platelet inhibitors and anti coagulants. Urokinase is also used to treat obstruction in blood flow. When medicines does not treat hypothenar hammer syndrome, then surgery is recommended. Via surgery, the embolism or painful mass is removed. The following surgical procedures are used:

  • Vascular procedures
  • Endoscopic thoracic sympathectomy
  • Intra arterial vasodilators.

Endoscopic thoracic sympathectomy do not give any good results as compare to other procedures.
Hypothenar Hammer Syndrome Definition, Symptoms, Causes, Treatment Hypothenar Hammer Syndrome Definition, Symptoms, Causes, Treatment Reviewed by Simon Albert on April 21, 2018 Rating: 5
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