The hypothenar hammer syndrome: update and literature review.

The hypothenar hammer syndrome is a rather rare vascular injury. It is seen in posttraumatic digital ischaemia caused by irregularity or occlusion of the distal ulnar artery at the level of the hamate bone. It characteristically occurs in the dominant hand of middle-aged men whose occupational or recreational activities require the use of the hand as a hammer. Three typical cases are presented along with literature review. The different aspects of this syndrome are described such as the cause and pathogenesis, the most important clinical characteristics and differential diagnosis, the role of angiography and Doppler mapping in establishing the diagnosis and the various therapeutic options, ranging from conservative treatment to resection of the thrombosed artery segment with vein graft interposition.