Posttraumatic aneurysms of the hand

Aneurysms should be suspected in patients with a mass in the hand following either open or closed trauma. Posttraumatic aneurysms are classified as true or false. False aneurysms usually result from penetrating trauma and can occur in any disrupted vessel. In contrast, true aneurysms usually occur in either the thenar or hypothenar eminence a few weeks following closed hand injuries. Pulsations may be evident. Symptoms are coolness or paresthesia of the digits and dull pain aggravated by exercise. A positive Allen's test is a helpful confirmatory sign in diagnosis. Treatment is surgical with resection of the aneurysm and primary anastomosis or vein graft when possible.