Hypothenar hammer syndrome: distal ulnar artery reconstruction with autologous descending branch of the lateral circumflex femoral artery

Abstract

Repetitive trauma to the hypothenar eminence can cause the ulnar artery to become aneurysmal, thrombose, or send emboli to the digital arteries. The symptoms and signs are also known as the hypothenar hammer syndrome. We postulate that an arterial autograft is a superior conduit to the traditional vein graft. In this article, we report 3 cases (2 in 1 patient) of reconstruction of the distal ulnar artery with the descending branch of the lateral circumflex femoral artery (LCFA). Two patients, ages 45 to 50 years, had severe ischemic complaints of the ulnar fingers. Arteriograms confirmed occlusion of the distal ulnar artery without direct perfusion of the superficial palmar arch. All reconstructions were carried out with the descending branch of the LCFA. From the ulnar artery at wrist level to the superficial palmar arch and the involved common digital arteries. Patency was certified during follow-up with color-coded Duplex sonography at 6 to 28 months. Preoperative complaints like cold intolerance and other ischemic symptoms disappeared.