# Acute Hypothenar Hammer Syndrome With Digital Ischemia in a Professional Rakugo Performer

## TL;DR

A professional Rakugo performer developed a rare hand condition causing blood flow issues after years of unnoticed trauma and alcohol use.

## Contribution

This case highlights the delayed acute presentation of hypothenar hammer syndrome linked to occupational trauma and alcohol.

## Key findings

- A thrombosed ulnar artery pseudoaneurysm was surgically treated in a Rakugo performer with digital ischemia.
- Excessive alcohol intake triggered acute symptoms after a decade of asymptomatic hand trauma.
- Occupational microtrauma and systemic factors can lead to delayed vascular complications.

## Abstract

We report a rare case of hypothenar hammer syndrome in a 59-year-old professional Rakugo performer who developed acute digital ischemia in the right hand. Imaging revealed a thrombosed ulnar artery pseudoaneurysm, which was surgically resected and reconstructed using a vein graft. The patient had a history of blunt hand trauma over a decade earlier but remained asymptomatic until sudden onset of ischemia following excessive alcohol intake. This case highlights the potential for delayed yet acute presentation of hypothenar hammer syndrome and underscores the importance of recognizing occupational microtrauma and systemic triggers in vascular hand conditions.