Hypothenar Hammer Syndrome: A Systematic Review and Meta-Analysis of Patency Rates and Patient-Reported Outcome...

Area of Science:

• Vascular Surgery
• Hand Surgery
• Orthopedic Surgery

Background:

• Hypothenar hammer syndrome (HHS) results from repetitive hand trauma.
• Surgical interventions for HHS include vein graft repair, arterial graft repair, and direct repair.
• Limited large studies exist on long-term patency and patient-reported outcomes for HHS surgical repairs.

Purpose of the Study:

• To review long-term patency rates and patient-reported outcome measures (PROMs) for HHS surgical interventions.
• To compare outcomes of vein graft repair, arterial graft repair, and direct repair without a graft.

Main Methods:

• Systematic review of 1399 publications, including 14 studies (13 for patency, 5 for PROM).
• Pooled analysis of patency rates and Disabilities of the Arm, Shoulder, and Hand (DASH) scores.
• Longitudinal analysis of patency rates based on graft type.

Main Results:

• Pooled patency rates: 65% for vein grafts (4.4% yearly decline), 100% for arterial grafts, 67% for direct repair.
• Arterial grafts demonstrated significantly higher longitudinal patency than vein grafts (P = .001).
• DASH scores were comparable between vein grafts and direct repair (10.9 vs. 11.5; P = .958).

Conclusions:

• Arterial grafts offer superior long-term patency for HHS surgical repair compared to vein grafts.
• Vein grafts show a declining yearly patency trend.
• Both vein grafts and direct repair provide comparable, favorable postoperative function and pain relief as measured by DASH and VAS scores.