title: Hypothenar hammer syndrome: a multicenter case-control study.
abstract: BACKGROUND
  The rarely diagnosed hypothenar hammer syndrome (HHS) is due to vascular damage to the distal part of the ulnar artery probably caused by acute or repetitive blunt trauma to the hypothenar region. To date, mainly case reports have been published, while epidemiological data are almost absent.
  
  
  OBJECTIVE
  To identify potential risk factors for HHS.
  
  
  METHODS
  An interview-based multicenter case-control study of 71 patients with HHS and 105 matched controls was conducted with standardized questions regarding disease specific variables, occupation, exposure of the hands to different types of trauma in occupational and leisure context. Medical data were verified from individual medical records.
  
  
  RESULTS
  Multivariable logistic regression analysis revealed that using the hand as a hammer on a daily basis (adjusted odds ratio [aOR] 17.04, 95% CI 5.51-52.67) daily pressure to the palm of the hand (aOR 4.96, 95% CI 1.39-17.71), and daily exposure to vibrating tools (aOR 3.41, 95% CI 1.03-11.31) were significant risk factors for HHS.
  
  
  CONCLUSIONS
  This investigation represents one of the largest groups of patients with HHS described so far. Work-related repeated blunt trauma to the palm of the hand significantly increases the risk of HHS.
authors.affiliation: Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Germany.
authors.forename: Jutta
authors.initials: J
authors.lastname: Scharnbacher
authors.forename: Matthias
authors.initials: M
authors.lastname: Claus
authors.forename: Jörg
authors.initials: J
authors.lastname: Reichert
authors.forename: Tobias
authors.initials: T
authors.lastname: Röhrl
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Kurt
authors.initials: K
authors.lastname: Ulm
authors.forename: Stephan
authors.initials: S
authors.lastname: Letzel
authors.forename: Dennis
authors.initials: D
authors.lastname: Nowak
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000453:epidemiology*; D016022:Case-Control Studies; D012090:Cumulative Trauma Disorders / Q000150:complications / Q000453:epidemiology*; D006230:Hand Injuries / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D007511:Ischemia / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060051:Occupational Injuries / Q000150:complications / Q000453:epidemiology*; D016017:Odds Ratio; D011928:Raynaud Disease / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013577:Syndrome; D017535:Ulnar Artery / Q000293:injuries*; D014732:Vibration / Q000009:adverse effects
keywords: Raynaud's phenomenon; etiology; hand trauma; hypothenar hammer syndrome; occupational; risk factors