Images in Clinical Medicine
Work-Related Vascular Injuries of the Hand — Hypothenar Hammer Syndrome
N Engl J Med 2002; 347:339August 1, 2002
- Article
Figure 1 A 47-year-old construction worker reported a two-month history of blanching of the second to fifth fingers and a recent ulcer on the tip of the third finger of his right hand. One week before the onset of symptoms, he had straightened a slab of iron with a hammer. Angiography (Panel A) revealed an aneurysm of the distal ulnar artery measuring 5 mm in diameter (large arrowhead) and occlusions of digital branches presumed to be secondary to thromboembolism (small arrowheads). Surgery revealed a partially thrombosed false aneurysm of the ulnar artery, which was resected. The postoperative course was uneventful, and the ulnar artery was shown to be patent.
A 42-year-old car mechanic noted blanching of the fourth and fifth fingers on exposure to cold and an ulcer on the tip of the fourth finger of his right hand. Symptoms developed after he jacked up a car with his right hand. Angiography (Panel B) revealed a stenosis of the distal ulnar artery (large arrowhead) and occlusions of digital branches in the fourth and fifth fingers presumed to be secondary to thromboembolism (small arrowheads). An aneurysm of the distal ulnar artery was ruled out by color-coded duplex sonography. The patient was treated successfully with a daily dose of aspirin. The ulcer healed, but the fingers continued to blanch on exposure to cold.
Manuela Birrer, M.D.
Iris Baumgartner, M.D.
Universitätsspital Bern, 3010 Bern, Switzerland- Citing Articles (1)
Citing Articles
1
Kyung Hoon Kim, Ji Min Kim, Eun Joo Song, Seung Woo Han, Eon Jeong Nam, Young Mo Kang. (2007) A Case of Hypothenar Hammer Syndrome Presented as Digital Ulcerations. The Journal of the Korean Rheumatism Association 14:4, 417
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