Ulnar artery aneurysm, thrombosis related ischemia or emboli of the fingers may occur from repeated blunt trauma to the hypothenar palm injuring the ulnar artery in Guyon's canal, referred to as "hypothenar hammer syndrome" or "hypothenar hammer hand". Often, symptoms of ulnar neuritis predominate. This is more common in smokers, may occur in young men, and may be confused with Buerger's disease. Treatment includes preoperative evaluation for possible hook of hamate fracture, and then excision of the diseased section of artery. If the artery is occluded, the patient is a smoker, and the remaining circulation is normal, simple excision and ligation is adequate. Otherwise, or based on the surgeon's preference, the segment may be repaired primarily or with a small vein graft. Hand arm vibration syndrome or vibration-induced white finger is a poorly understood syndrome in which patients exposed to vibrating hand-operated tools develop activity or cold related finger vasospasm. The most productive intervention for this appears to be avoidance of further hand vibration (Bovenzi). Digital artery thrombosis associated with closed ring avulsion injury (discussed below) has been reported, but is rare.
Vascular Injuries of the Hand