An Unusual Presentation of Hypothenar Hammer Syndrome

Hypothenar Hammer Syndrome (HHS) is a rare clinical entity that manifests as thromboembolic occlusive disease in the ulnar and digital arteries, or aneurysmal disease of the ulnar artery. It usually presents in middle-aged men and is generally associated with occupations involving repetitive trauma to the hypothenar aspect of the palm. We report the presentation, diagnosis, and treatment of a patient with late onset bilateral hypothenar hammer syndrome. We hypothesize that while his initial occupational exposure likely contributed to the aneurysm formation, the use of a rolling walker may have led to continued degeneration, and his late presentation.