The hypothenar hammer syndrome is an uncommon lesion of the ulnar artery caused by repetitive trauma to the ulnar portion of the hand. It characteristically occurs in the dominant hand of middle-aged craftsmen, but also in athletes practising various types of sports. We present a retrospective study of nine patients between 1988 and 1999. The follow-up ranged from 1 to 10 years. We recommend surgical treatment, by resection of the involved arterial segment and revascularization either by direct anastomosis or by means of a venous interpositional graft.

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Abstract:Patients with osteomyelitis require lengthy antibiotic treatment, often only to see the inflammation flare up once antibiotics are suspended. Unfortunately, patients often discontinue the antibiotic treatment due to collateral effects. Patients with osteitis are often polymorbid patients with other severe diseases such as diabetes mellitus and polyneuropathy, arteriopathy or polyarthritis with immunosuppression. The eight patients included in the study presented nine bones with osteomyelitis (macroscopically, bacteriologically, histologically or radiologically). The diseased part of the bone was resected, a locally radical debridement was done and a biopsy for bacteriology and histology were taken. The residual bone was then drilled out and filled with antibiotic-loaded (gentamicin) resorbable bone-graft substitute under radiologic imaging control. In total, seven patients are currently without recurrent osteomyelitis with a mean follow-up of 5.77 months (2~11 months). The Kaplan Meier curve shows 80% survival rate without recurrent osteomyelitis at 11 months. Only one patient suffering from Morbus Buerger had a relapse osteomyelitis after cutting off severing his foot while swimming in the sea. Antibiotic-loaded resorbable bone-graft substitute is easy to use, has in our hands few complications and low recurrence rate.