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KMID : 0388220070140040417
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Journal of the Korean Rheumatism Association
2007 Volume.14 No. 4 p.417 ~ p.421
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A Case of Hypothenar Hammer Syndrome Presented as Digital Ulcerations
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Kim Kyung-Hoon
Nam Eon-Jeong
Kang Young-Mo
Song Eun-Joo
Kim Ji-Min
Han Seung-Woo
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Abstract
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Hypothenar hammer syndrome (HHS) is a non-atherosclerotic, non-inflammatory vascular disease that causes a digital ischemia as a result of the occlusion of distal ulnar artery adjacent to the hook of hamate. This syndrome is usually observed in men who use the hypothenar eminence of the hand to grip devices such as a hammer. As a consequence of repeated blunt trauma, the ulnar artery beneath hypothenar eminence may lead to pathologic changes, such as intima-medial hyperplasia and reactive inflammatory infiltrates, which lead to the digital ischemia. We experienced a case of HHS with digital ulcerations which occurred after intensive work with nail remover for 10 days. Selective angiography of right forearm showed complete occlusion of the ulnar artery at the level of hook of hamate with deficient superficial palmar arch. After treatment with intravenous prostaglandin E1 and heparin, the ulcerative lesions of fingers improved without surgical intervention, which implicates that medical management of HHS should be considered prior to the surgical treatment.
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KEYWORD
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Hypothenar hammer syndrome, Finger ulceration
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