[Hammer hypothenar syndrome: review of the literature and case report].
Hypothenar hammer syndrome is a rare disease first described by Conn et al. in 1970. It groups together symptoms of chronic microtraumatism to the ulnar artery or its superficial palmar branch against the hamate. Manual workers using vibrating tools are the most affected by this. Diagnosis is made by echodoppler, while arteriography is the gold standard for establishing the treatment plan. Hypothenar hammer syndrome may lead to severe complications secondary to ischemia and to embolic events resulting from delayed diagnosis or maltreatment. There is no real consensus as to the place of medical or surgical treatments. Medical treatment consists of eliminating favorizing factors and long-term antiplatelet aggregation treatment. Surgical treatment depends on the vascular lesions: simple arterial ligation, resection of the thrombosed arterial segment and end-to-end anastomosis, or revascularization using a pontage venous or arterial graft. Some authors suggested an associated thoracic sympathectomy. The diagnosis must be made early; the choice of treatment must be targeted at preventing serious embolic complications.
Dumas
P
P
Service de chirurgie plastique reconstructrice et esthétique, hôpital Saint-Roch, Nice, France. pierredumas06@hotmail.com
Chignon-Sicard
B
B
de Chardon
V Médard
VM
Balaguer
T
T
Lebreton
E
E
D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D051225:Hamate Bone / Q000293:injuries*; D053421:Hand-Arm Vibration Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects* / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011859:Radiography; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013562:Sympathectomy / Q000379:methods; D016896:Treatment Outcome; D017535:Ulnar Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014463:Ultrasonography; D014732:Vibration / Q000009:adverse effects
D010975:Platelet Aggregation Inhibitors