The Corkscrew Sign in Hypothenar Hammer Syndrome

Abstract

Arteriography of an adult manual labourer presenting with numbness and cold intolerance in the middle and ring fingers of the right hand demonstrated filling defects in the digital arteries of these two fingers associated with a corkscrew-like configuration of the ulnar artery in Guyon’s canal. This arterial segment was subsequently excised revealing intramural necrosis and fibrosis and non-occlusive intraluminal thrombosis. An arteriogram performed 2 years previously for an unrelated condition revealed a similar but less pronounced corkscrew configuration of the artery, suggesting that this finding could be a marker for arterial injury which may eventually lead to embolization or thrombosis with accompanying ischaemic symptoms.