[Progressive ischaemia of the hand caused by aneurysm]

Arterial aneurysmata of the hand represent a rarity. Post-traumatic aneurysms of the ulnaric artery are subsumed under the so-called hypothenaric or hammer syndrome. This report describes a 36-year-old patient with a symptomatic aneurysm of the superficial palmaric arc distal to the ulnaric artery outside of the Loge de Guyon. The branches of the communicating digital arteries were part of the aneurysm. Unable to recall any trauma to the left hand, the patient had an impaired blood supply to the left second, fourth, and fifth fingers. He complained of unpleasant paleness, cold sensation, and pain there. Particularly remarkable was the absence of an anastomosis of the superficial and profound arterial arcs. The therapy was microsurgical resection of the aneurysm with end-to-end anastomosis of the superficial palmaric arc and reinsertion of the communicating digital arteries 4 and 5. After release of a haematoma, the wound healed without any complications and the complaints ceased. The suggested therapy concerning a cardiac infarction 5 years prior to the treatment was: 300 mg of aspirin for 12 months followed by 100 mg as a permanent medication.