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Ulnar artery thrombosis 25-Aug-2017 At 7:21:40 AM Lingy

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Just wondering if anyone’s had any experience with ulnar artery thrombosis (basically, a painful blood clot that develops in the palm of your hand as a result of trauma)? Also known as ‘hypothenar hammer syndrome’, ‘posttraumatic digital ischemia’, and ‘pneumatic tool disease’. Having recently been diagnosed with this after experiencing increasing weakness, pain and paresthesia in my left hand (associated with a tense/tender lump in my palm), I’m surprised to find no mention of it in relation to climbing (at least, not on the internet). The aetiology suggests it’s the kind of thing we should see more of in climbers. From an article in Acta Orthopaedica Scandinavica:

“The reason why thrombi and aneurysms form in this part of the ulnar artery is presumedly because the artery in this area is especially exposed to trauma. It may be a question of repeated minor trauma, as in monotonous work, with consequent pressure of this segment of the ulnar artery against the deeper structures (e.g. working with pneumatic tools, gear shifts etc.). Or, it may be a question of a more acute, heavy trauma […]. Since such trauma is very common, it seems strange that the disease does not occur more often. The explanation might be that the relationship to trauma is not so precise, or that the disease is more common than supposed and that it is often misdiagnosed.”

In my case, my symptoms date back to a fairly decent accident I had in 2015, but sharply increased two months ago after repeated falls on a route that ended with me bashing my palm against the rock. Given that this is a fairly common phenomena in rock climbing (especially sport climbing where repeated pendulum-esque falls are pretty much par for the course), I’m interested to hear if anyone else has any experience of it?

My suspicion is that it actually occurs in climbers with some degree of regularity but is misdiagnosed or even ignored (the symptoms can vary significantly in intensity). Every article I’ve read highlights the fact that it frequently goes unrecognised (in my case, my symptoms pointed to a break of the hook of hamate, but x-rays said nix; CT scan showed oedema and deformity of the HoH, but nothing conclusive; it was finally picked up through ultrasound).

Cheers,
Alex