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Hypothenar Hammer Syndrome (HHS)

One of the conditions identified as a neurovascular overuse condition, Hypothenar Hammer Syndrome (HHS) is an overuse injury that is often the result of a constant pounding on the ulnar side of the palm of the hand affecting the hypothenar region. It is often related to excessive biking, karate, and lacrosse - as well as the use of a jackhammer or constant hammering required in roofing.

It is generally prompted by a trauma to the ulnar artery distal to Guyon’s canal, which leads to ischemia, or thrombosis of the ulnar artery in the hand. Symptoms often include sensitivity to cold and pain in the palm, as well as ulnar digital numbness and tingling. In more severe cases, patients may experience a weakness of grip, finger discoloration and ulcer of the fingertip.

Those at Risk
Manual labor workers involved in activities that subject their hands to a harsh, constant pounding are most frequently diagnosed with the condition. Though, it can also affect some athletes as well.

Diagnosis
Often the patient's medical and job history will contribute to the diagnosis of HHS. The location of the discomfort combined with appropriate scans to determine blood vessel obstruction will confirm it and help determine treatment.

Treatment
Refraining from the activity that prompted the condition is the first course of action. Medication to help restore blood flow may also be indicated. And surgery is required in severe cases.