Hypothenar Hammer Syndrome: Case Reports and Brief Review

Ct, Ablett; La, Hackett

doi:10.3121/cmr.2008.775

Cited by 80 publications

(123 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Typically, patients are male, with a mean age of 40 years, who present with progressive pain and tenderness over the hypothenar eminence and ischemic complications of the digits. The dominant hand is commonly affected (1,2). Cold sensation, paresthesia, blanching, cyanosis, and atrophic ulceration should suggest the possibility of HHS.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Man with Finger Pain and Ulceration: A Case of Hypothenar Hammer Syndrome

Wendell

Bloch

Higgins

2012

The Journal of Emergency Medicine

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

“…Conservative management, including smoking cessation, avoidance of further trauma, calcium channel blockers, anti-platelet agents, and pentoxifylline, are often effective (1,3). Surgical options may be required for severe ischemia (2).…”

Section: Discussionmentioning

confidence: 99%

A Man with Finger Pain and Ulceration: A Case of Hypothenar Hammer Syndrome

Wendell

Bloch

Higgins

2012

The Journal of Emergency Medicine

View full text Add to dashboard Cite

“…Unlike CTA or MRA, angiography can provide detailed arterial anatomy in the rather complex and variable hand vasculature, which is often helpful in surgical planning. 10 Regardless of the imaging modality, it is important to thoroughly assess the proximal segments in order to not miss a proximal source of obstruction or embolization. 14 Arteriographic findings in HHS commonly show alternating areas of stenosis and ectasia (corkscrew) of the palmer ulnar artery (Figure 4).…”

Section: Imaging Modalities In the Diagnosis Of Hhsmentioning

confidence: 99%

“…9 The superficial palmar arch, supplied principally by the ulnar artery, is the main blood supply for most of the fingers. 10 In contrast to the deep palmer arch, the superficial palmar arch displays much greater anatomical variability and is often incomplete. Further, its completion on the radial side is often diminutive or absent.…”

Section: Introduction and Underlying Pathophysiologymentioning

confidence: 99%

Hypothenar hammer syndrome: A case and brief review

2011

View full text Add to dashboard Cite

A 51-year-old, right-handed, Caucasian, male factory mechanic with an underlying history of active tobacco abuse, hypertension and hyperlipidemia, awoke with severe, throbbing, left hand pain. His hand felt 'ice-cold'; 'like someone pulled my fingernails out'. He denied previous trauma of the involved upper limb or hand. He denied similar past symptomatology. Home medications included zolpidem, simvastatin, losartan, celecoxib, amitriptyline and diltiazem. His work activities were physically demanding, involving heavy use of his hands. He described a history of frequently using his left hand for pounding during previous employment as a farmer. For the previous 6 years, he had been employed as a factory mechanic, requiring less overall use of the left hand as a hammer, though he did still use this technique. Pounding activities using the right hand were much less frequent.He sought initial evaluation in the emergency department where Raynaud's phenomenon was suspected and a trial of cilostazol started. Symptoms, however, progressed to dusky, cyanotic-appearing 2nd, 3rd, 4th, and, to a lesser extent, 5th digits ( Figure 1) with worsening pain and hypersensitivity. Early signs of tissue loss were noted at the tip of the long finger (Figure 2 AbstractHypothenar hammer syndrome is an uncommon cause of upper-extremity ischemia that is often overlooked in the absence of a thorough occupational and recreational history. Importantly, it is a reversible cause of hand ischemia that, if missed, can lead to significant morbidity and even amputation. The occupational ramifications and quality of life of those affected can be significant. Its relative rarity, set against the ubiquitous use of the hand as a 'hammer' is noteworthy. Several other causes of hand ischemia can present similarly; therefore, consideration of other etiologies must be thoroughly investigated. Key distinguishing clinical features, in addition to a detailed occupational and recreational history, may include characteristic sparing of the thumb, the absence of a hyperemic phase in 'Raynaud's phenomenon', and a positive Allen's sign. Both non-invasive and invasive diagnostic studies, including bilateral upper-limb segmental pulse volume recordings (PVR), arterial duplex examination, and upper-extremity angiography, are complementary to a thorough history and physical examination. Optimal management strategies are not well defined because of its rarity and resultant lack of quality, evidence-based data. Though most cases can be successfully managed non-operatively, micrographic arterial reconstruction may be limb saving in severe or recalcitrant cases. Newer, experimental strategies including selective sympathetic blockage using botulinum toxin A have been reported in a few recalcitrant cases. The brief case description illustrates the typical presentation and potential treatment strategies employed in a difficult case. A review of relevant literature is also presented.

show abstract

“…Hypothenar hammer syndrome is most commonly observed in people exposed to acute blunt, vibratory, or repetitive chronic trauma to the hypothenar muscles like in carpal tunnel. [1][2][3][4] Hypothenar hammer syndrome is difficult to diagnose and when not treated timely, may lead to serious complications including amputation. [1] Of note, ischemia associated with HHS is reversible.…”

mentioning

confidence: 99%

Hypothenar hammer syndrome: a case series and literature review

Şahin¹

2015

Eklem Hastalik Cerrahisi

View full text Add to dashboard Cite

ÖZAmaç: Bu çalışmada hipotenar çekiç sendromu nedeniyle cerrahi tedavi yapılan hastalarla ilgili deneyimlerimiz sunuldu ve ilgili literatür gözden geçirildi. Hastalar ve yöntemler: Çalışmaya Eylül 2004 -Mart 2013 tarihleri arasında hipotenar çekiç sendromu nedeniyle cerrahi geçiren sekiz hastanın (5 erkek, 3 kadın; ort. yaş 48 yıl; dağılım 29-60 yıl) 11 eli dahil edildi. Ortalama takip süresi 50 aydı (dağılım 3-103 ay). Semptom başlama zamanı, mesleki öykü ve ayrıntılı fizik muayene bulguları kaydedildi. Cerrahi sedasyon ve aksiller anestezi altında gerçekleştirildi. Ön kolun distal kısmı, Guyon ve yüzeyel arktaki tüm tromboze kısımlar çıkartıldı. Ulnar arter ve yüzeyel ark rekonstrüksiyonları ön koldan alınan ven greftleri kullanılarak yapıldı. Bulgular: Hastaların tamamının dominant eli etkilenirken üç hastada iki el etkilenmişti. Tüm hastalar bir veya birkaç parmağında ağrı ve renk değişikliğinden yakındı. İki hastanın parmak ucu pulpasından minimal amputasyon ve debridman yapılırken diğer hastaların tamamı sorunsuz iyileşti. Takiplerinde, sekiz hastanın beşinde ulnar arter açıklığı sorunsuz iken üç hastaya yeni ven grefti için revizyon cerrahisi yapıldı. Hastaların yakınmalarının çoğu takip sürecinde ortadan kalktı. Sonuç: Hipotenar çekiç sendromu, parmak iskemisi ve el işleri ile sigara öyküsü olan hastalarda dikkate alınması gereken, üst ekstremitelerin bir hastalığıdır. Bu hastalık konservatif olarak tedavi edilebilse de konservatif tedaviye yanıt vermeyen ileri dönem hastalar ven greftleri ile cerrahi olarak tedavi edilebilir.Anahtar sözcükler: Arter rekonstrüksiyonu; parmak iskemisi; hipotenar çekiç sendromu; ulnar arter; ven grefti. ABSTRACTObjectives: This study aims to report our experience regarding patients who were surgically treated due to hypothenar hammer syndrome and review the related literature. Patients and methods: The study included 11 hands of eight patients (5 males, 3 females; mean age 48 years; range 29 to 60 years) who underwent surgery due to hypothenar hammer syndrome between September 2004 and March 2013. Mean follow-up period was 50 months (range 3-103 months). The time of symptom onset, occupational history, and detailed physical examination findings were recorded. Surgery was performed under sedation and axillary anesthesia. Distal segment of the forearm, all thrombosed segments of the Guyon and superficial arch were removed. Reconstruction of the ulnar artery and the superficial arch was performed using vein grafts obtained from the forearm.

show abstract

Hypothenar Hammer Syndrome: Case Reports and Brief Review

Cited by 80 publications

References 24 publications

A Man with Finger Pain and Ulceration: A Case of Hypothenar Hammer Syndrome

A Man with Finger Pain and Ulceration: A Case of Hypothenar Hammer Syndrome

Hypothenar hammer syndrome: A case and brief review

Hypothenar hammer syndrome: a case series and literature review

Contact Info

Product

Resources

About