Hypothenar Hammer Syndrome in Workers Occupationally Exposed to Vibrating Tools

Abstract

Among 330 vibration-exposed workers, 24 cases of hypothenar hammer syndrome in 29 hands were diagnosed by arteriography. The right hand was involved in 13, the left hand in six, and both hands in five cases. The mean age was 55 years, mean duration of vibration exposure 19.4 years, and mean duration of episodic Raynaud's phenomenon 6.4 years. The vascular lesions of the ulnar arteries were classified into three major types with subtypes. Type 1: stenosis of the superficial palmar arch around the hook of the hamate. Type 2a: occlusion of the superficial palmar arch around the hook of the hamate. Type 2b: occlusion of both superficial and deep palmar arches around the hook of the hamate. Type 3a: occlusion of the ulnar artery at the proximal part of the wrist. Type 3b: occlusion of the ulnar artery near the wrist with the occlusion of the dorsal carpal branch of the ulnar artery.

Effect of impulse vibration on red blood cells in vitro

“…It has been suggested that shear stress arterially is provoked by impulse vibration and that it contributes to circulatory disorders (11). In addition, hypothenar hammer syndrome, in which stenosis or occlusion can be detected in the ulnar artery at the hypothenar part of the hand, has been observed to occur among workers using percussion tools such as impact wrenches and chipping hammers (12). Repetitive blunt trauma in the palm originating from vibratory tools is suggested to result in the syndrome.…”

Hypothenar Hammer Syndrome: Case Reports and Brief Review

“…Hypothenar hammer syndrome was found in 7% of one group of 330 vibration-exposed workers. 9 It can occur occasionally in athletes who experience trauma to the palm and has been reported in baseball, karate, badminton, mountain biking, golf, tennis, handball, volleyball, softball, weight lifting, break-dancing and hockey. Occasionally, a single episode of significant trauma can be the cause of hypothenar hammer syndrome.…”

“…In one series, however, the Allen test was negative in 14% of patients with hypothenar hammer syndrome. 9 Others have observed that the Allen test is lacking in specificity with positive findings in 22% of normal patients. 19 Noninvasive testing that can be helpful in establishing the diagnosis of hypothenar hammer syndrome includes thermography, cold stress testing, digital pulse volume recordings and plethysmography.…”

Thenar Hammer Syndrome: Case Report

“…17 Trombozun ortaya konmasında ya da digital iskemiye neden olan diğer faktörlerden ayırt edilmesinde Doppler ultrasonografik inceleme oldukça yararlı-dır. BT/MRG anjiografileri ve sintigrafi diğer tanı-sal görüntüleme metotları arasında sayılabilir; ancak çekiç sendromunda altın standart test anjiografidir.…”