title: ["Progressive" hypothenar hammer syndrome Indication for operative treatment].
abstract: Hypothenar hammer syndrome (HHS) is ischemia of the distal ulnar artery caused by injury to the ulnar part of the palmar arch. This disease often involves workers who frequently use the hypothenar part of the hand as a hammer. The aneurysmatic form of HHS represents an indication for operative treatment; the thrombotic form is treated mainly conservatively. In our opinion, the symptomatic thrombotic form represents an indication for operation if symptoms persist during conservative therapy, particularly if symptoms progress. In fresh embolic occlusions, regional thrombolysis is usually successful. We present here the symptomatic treatment and course in two patients with complaints increasing during conservative therapy. The patients reported progressive Raynaud's phenomenon of the fingers. Angiography confirmed corkscrew-like aneurysmatic configuration of the distal ulnar artery and subsequent embolization of digital arteries. In both cases, we removed the source of the embolism with resection of the involved arterial segment and anastomosis with autologous vein grafts.
authors.affiliation: Klinik und Poliklinik für Unfallchirurgie der Universitätskliniken Mainz. Dklitscher@aol.com
authors.forename: D
authors.initials: D
authors.lastname: Klitscher
authors.forename: L P
authors.initials: LP
authors.lastname: Müller
authors.forename: L
authors.initials: L
authors.lastname: Rudig
authors.forename: N
authors.initials: N
authors.lastname: Simiantonaki
authors.forename: G
authors.initials: G
authors.lastname: Arnold
authors.forename: P M
authors.initials: PM
authors.lastname: Rommens
mesh_terms: D000328:Adult; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D000792:Angiography; D012090:Cumulative Trauma Disorders / Q000175:diagnosis; D003937:Diagnosis, Differential; D018450:Disease Progression; D004617:Embolism / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005385:Fingers / Q000098:blood supply; D006055:Golf / Q000293:injuries; D006225:Hand / Q000098:blood supply*; D006801:Humans; D008297:Male; D011182:Postoperative Care; D011928:Raynaud Disease / Q000209:etiology; D013577:Syndrome; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D014182:Transplantation, Autologous; D017535:Ulnar Artery / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D014680:Veins / Q000637:transplantation
chemical_list: D005343:Fibrinolytic Agents