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Recurrent Hypothenar Hammer Syndrome: A Case Report.

Nicholas S Adams1, Ronald D Ford1,2

  • 1* Grand Rapids Medical Education Partners/Michigan Stage University Plastic Surgery Residency, Grand Rapids, USA.

The Journal of Hand Surgery Asian-Pacific Volume
|September 7, 2016
PubMed
Summary

Hypothenar hammer syndrome (HHS), a rare condition from palm trauma, can recur even after surgery. This case highlights the first documented instance of recurrent HHS, emphasizing the need for awareness in at-risk occupations.

Keywords:
Digital ischemiaHand painHypothenar hammer syndromeRecurrentUlnar arteryUlnar hammer syndrome

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Area of Science:

  • Vascular Surgery
  • Occupational Medicine

Background:

  • Hypothenar hammer syndrome (HHS) is a rare condition resulting from repetitive trauma to the palm, often linked to occupational activities.
  • It can lead to digital ischemia, pain, thrombosis, and embolization, typically treated with surgical excision and reconstruction.

Observation:

  • A 55-year-old pipe fitter, previously treated for HHS with vein graft reconstruction in the 1980s, presented again 30 years later.
  • He continued his profession, involving regular palm-hammering, and reported recurrent cold intolerance and pain.

Findings:

  • Angiography revealed ulnar artery occlusion with distal emboli, confirming recurrent HHS.
  • The patient underwent repeat surgical excision and reconstruction for the recurrent condition.

Implications:

  • This case represents the first documented instance of diagnosed and treated recurrent Hypothenar Hammer Syndrome.
  • It underscores the potential for HHS recurrence in individuals with ongoing occupational risk factors.
  • Highlights the importance of long-term monitoring and patient education for those with a history of HHS.