BACKGROUND: Ulnar artery thrombosis in the hand is a rare presentation. This condition is also called hypothenar hammer syndrome, and it can be caused by local hand trauma or insults to proximal shoulder arteries leading to thromboembolism. CASE PRESENTATION: A 19 years-old male left-handed semi-professional volleyball player was referred by a physiotherapy clinic for a second opinion. The athlete developed left sided shoulder, arm, forearm, and hand pain during an intense spiking session, which led him to discontinue training. During the session, he also developed blanching of the left middle fingertip, which resolved within minutes. Within two weeks after initial symptoms onset, finger blanching developed into persistent discoloration with reduction in hand temperature compared to the unaffected side. An emergency ultrasound imaging revealed thrombosis of the ulnar artery at the hand and the patient was hospitalized. OUTCOME AND FOLLOW-UP: The athlete was referred to the emergency department where physicians excluded proximal arterial insults responsible for the hand ischemia. A diagnosis of hypothenar hammer syndrome was made, and he was prescribed with antithrombotic therapy. The patient remained in the hospital for one week to exclude cardiovascular and systemic pathologies responsible for the thrombosis. The patient returned to high levels of competition within six months from injury. DISCUSSION: The case described presented with hypothenar hammer syndrome associated with local trauma to the hand. The presence of proximal shoulder and arm symptoms was incidental and unrelated to the hand ischemia. Overall, the patient experience had been stressful due to the uncertainty regarding return to sport during the initial treatment phase.
Magni et al. (Mon,) studied this question.