[Hypothenar hammer syndrome: case report and review of the literature].
BACKGROUND
Hypothenar hammer syndrome is a rare cause of upper extremity digital ischemia or Raynaud phenomenon, a diagnosis which should be considered in cases of iterative palmar trauma. Its treatment can be medical or surgical and should not suffer any delay. The best options remain controversial.


METHODS
A 65-year-old patient presented with an ischemia of the last three fingers of the left hand. A partially thrombosed aneurysm of the left ulnar artery was diagnosed at imaging. After a partially effective medical treatment, a surgical treatment was performed with resection of the aneurysm and a vascular reconstruction with an autologous vein graft. The postoperative course was uneventful with disappearance of the symptoms and revascularization of the hypothenar area.


CONCLUSIONS
Appropriate treatment for hypothenar hammer syndrome is controversial but whould always begin with medical care. The decision to perform surgery should be based on evidence of ulnar artery lesions and the associated symptoms.
Service de chirurgie viscérale et vasculaire, HIA du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris cedex 05, France. Electronic address: bricemalgras@hotmail.com.
B
B
Malgras
Service de chirurgie viscérale et vasculaire, HIA du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris cedex 05, France.
A
A
Mlynski
Service de chirurgie viscérale et vasculaire, HIA du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris cedex 05, France.
C
C
Pierret
Service de chirurgie viscérale et vasculaire, HIA du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris cedex 05, France.
S
S
Fossat
Service de chirurgie viscérale et vasculaire, HIA du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris cedex 05, France.
X
X
de Kérangal
D000368:Aged; D000783:Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D006225:Hand / Q000098:blood supply* / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D058226:Plaque, Atherosclerotic / Q000150:complications; D011928:Raynaud Disease / Q000150:complications*; D017131:Thrombectomy; D013927:Thrombosis / Q000209:etiology* / Q000601:surgery; D017535:Ulnar Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014463:Ultrasonography
Digital ischemia; Hypothenar hammer; Ischémie digitale; Marteau hypothénarien; Phénomène de Raynaud; Raynaud phenomenon