2010 Volume 59 Issue 3 Pages 489-492
The case was a 15-year-old male whose chief complaint was feeling of coldness in his right ring finger. He had three years of experience playing baseball. In early July 2009, he bruised his right hypothenar area against the floor. He began feeling coldness in his right ring finger three weeks after the injury and thus visited our hospital. The right ulnar artery tested positive in the Allen test and the temperature of the fingertip area of the right ring finger was 28.0°C, which was a low value, namely 4.5°C lower than on the unaffected side, and the temperature of each remaining finger had also decreased, although only mildly. An ultrasound examination revealed an aneurysm in the ulnar artery at a slightly distant level of the hamate bone, and while blood flow was observed in the periphery of this region, blood flow was observed to become weak when the radial artery was compressed. A decrease in the amplitude of the fingertip pulse wave was observed in the right ring finger. An angiographic examination revealed advanced stenosis on the peripheral side of the ulnar artery and contrast delay was observed. Compared to the stenosed area, the peripheral blood vessels were relatively smooth, but no blood flow toward the superficial palmar arch was observed. Based on the above findings, the patient was diagnosed to have right hypothenar hammer syndrome and an aneurysmectomy and revascularization were performed. As of approximately one month after the surgery, the temperature and pulse wave of the fingertip area were found to have improved and the symptoms had disappeared.
