Combined thenar and hypothenar hammer syndromes: case report and review of the literature.
Patients who use the palms of their hands as a hammer may cause irreversible damage to the radial or ulnar arteries. Damage to the intima may lead to arterial thrombosis, whereas damage to the media may cause aneurysm formation with embolization to the digital arteries, causing symptoms of ischemia. These patients may have symptoms of Raynaud syndrome, or they may have ischemic ulcerations of their fingers. Hypothenar hammer syndrome with involvement of the ulnar artery is much more frequently encountered than thenar hammer syndrome, which is caused by damage to the radial artery. We report a patient with symptomatic occlusion of both the radial and ulnar arteries secondary to repetitive trauma to the palm of his hand. In our review of the literature, we found two reports involving a total of four patients with similar findings. Both conservative and surgical treatments have been used successfully. Avoidance of the precipitating activities is important in long-term management of these patients.
McCready
Robert A
RA
Division of Vascular Surgery, Methodist Hospital, Clarian Health Partners, Indianapolis, Indiana, USA. rmccgoirish@aol.com
Bryant
M Ann
MA
Divelbiss
Janet L
JL
D000328:Adult; D000783:Aneurysm / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D001157:Arterial Occlusive Diseases / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D012090:Cumulative Trauma Disorders / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006230:Hand Injuries / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000150:complications* / Q000473:pathology / Q000601:surgery; D017534:Radial Artery / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D012501:Saphenous Vein / Q000637:transplantation; D013577:Syndrome; D016896:Treatment Outcome; D017535:Ulnar Artery / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D018615:Ultrasonography, Doppler, Color