Ulnar Artery Pseudoaneurysm Following Penetrating Palm Injury: A Case Report

Ulnar artery pseudoaneurysms (UAPs) are rare vascular injuries resulting from trauma, surgery, or repetitive stress, potentially leading to ischemia, embolization, or nerve compression. Early recognition and appropriate management are crucial to prevent complications. This report presents a 17-year-old male who sustained a penetrating glass injury to the left palm, resulting in ulnar artery laceration. After initial ligation, he developed a progressively enlarging, bleeding palm mass. Examination revealed a 4 cm pseudoaneurysm with intact nerve and tendon function. Imaging confirmed a pseudoaneurysm from the transected ulnar artery. Surgical intervention included pseudoaneurysm excision, neurolysis, and vein graft reconstruction using a reversed 4 cm vein graft. The patient recovered fully with preserved hand function. Traumatic UAPs can present with delayed complications, requiring careful evaluation. While ligation is sometimes sufficient, vein grafting is preferred for restoring arterial continuity and preventing ischemic complications. This case highlights the importance of early diagnosis and timely surgical intervention. Vein graft reconstruction remains a reliable approach for preserving hand function, and a multidisciplinary strategy ensures optimal patient outcomes.