Isolated Ulnar Artery Injury: Indications for and Timing of Operative Intervention

Rachel H Safeek, MD, MPH; Adam O'Toole, MD; Wilfred R Furtado, BS; Bradon J Wilhemi, MD; Joshua H Choo, MD


ePlasty. 2022;22(e37) 

In This Article

Abstract and Introduction


Background: Penetrating ulnar artery injury at the wrist is typically treated with immediate operative repair. This study reports a missed iatrogenic ulnar artery injury that resulted in the development of an ulnar artery pseudoaneurysm that was later managed with elective operative repair. The diagnosis and treatment of distal upper extremity pseudoaneurysms and the approach to suspected ulnar artery injury are discussed. Suspected isolated ulnar artery injuries without hard signs of bleeding can be managed with close follow-up and elective repair, should complications such as pseudoaneurysm occur.


Upper extremity peripheral artery aneurysms are rare, accounting for only 0.5% of all peripheral artery aneurysms.[1,2] Pseudoaneurysms are defined by extravasation of blood into a false lumen confined by the tunica adventitia or perivascular tissue, in distinction to a true aneurysm, which involves all three layers of the arterial wall.[1] The ulnar artery is a rare location for both true and false aneurysms, with hypothenar hammer syndrome accounting for most reported cases.[3] Here, we present a case of a distal forearm ulnar artery pseudoaneurysm occurring in an iatrogenic manner that was managed on an elective basis.