The ulnar artery gives hypothenar branches in Guyon's canal and as it enters the palm, supplying the hypothenar muscles (abductor, flexor, opponens digiti minimi) and the little finger structures via the superficial palmar arch.
The hypothenar ulnar artery branches are compressed in hypothenar hammer syndrome, producing digital ischaemia and ulnar neuropathy. Doppler assessment of hypothenar perfusion after ulnar artery trauma guides the need for vascular repair. In ulnar artery aneurysm, the hypothenar branches may receive reversed flow from palmar arch collaterals.
Loss of hypothenar artery supply from ulnar artery thrombosis producing hypothenar pallor and little finger ischaemia, managed by ulnar artery reconstruction or digital sympathectomy.
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