Author(s): Mario Metry, Zainab Shakoor, Mohamed Shaaban, Mr. Adam Sowiniski.

Distal ulnar artery aneurysms, although uncommon, have been well described in adults as a clinical finding as a part of the hypothenar hammer syndrome. Congenital true aneurysms of the ulnar artery, however, are rare. The diagnostic and treatment algorithms for ulnar artery aneurysm are not well established because the disease is very rare. Discussion: There should be a clear defined algorithm for Diagnosing and treatment of Hand Aneurysms. In this paper we are discussing the literature review of the small hand aneurysm m, mainly the ulnar artery and also giving an example from our practice of case that presented with us with Small thrombosed ulnar aneurysm that we dealt with it with our best practice at the time. Therefore the need for clarification of the possible management ways of the peripheral hand aneurysms have issued and this literature review was done for discussing the possible ways along with the preferred methods for managing peripheral hand aneurysms. Conclusion: Treatment of ulnar artery aneurysms should notbe determined by the presence of symptoms. The development of thromboembolic complications with subsequent finger and hand ischemia can occur without warning signs. The surgical options for ulnar artery aneurysms depend on the presence of adequate perfusion in the hand after the aneurysm is excluded from the hand circulation. The reconstruction can be achieved by a primary end-to-endanastomosis if there is no tension or with the use of an interposition vein graftif the defect is large. So, we conclude that an algorithm needs to be existed for the treatment of such rare conditions.