A Case of Thenar Hammer Syndrome

Abstract

Thenar hammer syndrome (THS) is characterized by vascular injury and subsequent digital ischemia from acute high-energy trauma or repetitive low-energy trauma to the thenar eminence of the palm. Here, we report the case of a 41-year-old male construction worker who presented with unilateral, cold, painful, and blue-colored fingertips in his left hand. Angiography of his left upper extremity showed abrupt occlusion of the radial artery at the level of the radial styloid process with a poorly developed but patent deep palmar arch, consistent with THS. The ulnar artery and superficial palmar arch were both patent. He had moderate symptomatic relief with administration of low-dose endovascular fibrinolytics, anticoagulation therapy, and a calcium channel blocker during his stay in the hospital and was discharged home on dual antiplatelet therapy.