 |
CLOSED
VASCULAR INJURIES
Ulnar
artery aneurysm, thrombosis related ischemia or emboli of the fingers may
occur from repeated blunt trauma to the hypothenar palm injuring the
ulnar artery in Guyon's canal, referred to as "hypothenar hammer
syndrome" or "hypothenar hammer hand". Often, symptoms of ulnar neuritis
predominate. This is more common in smokers, may occur in young men, and
may be confused with Buerger's disease. Treatment includes preoperative
evaluation for possible hook of hamate fracture, and then excision of the
diseased section of artery. If the artery is occluded, the patient is a
smoker, and the remaining circulation is normal, simple excision and ligation
is adequate. Otherwise, or based on the surgeon's preference, the segment
may be repaired primarily or with a small vein graft. Hand arm vibration
syndrome or vibration-induced white finger is a poorly understood syndrome
in which patients exposed to vibrating hand-operated tools develop activity
or cold related finger vasospasm. The most productive intervention for
this appears to be avoidance of further hand vibration (Bovenzi). Digital
artery thrombosis associated with closed ring avulsion injury (discussed
below) has been reported, but is rare.
Blunt
Vascular Injuries of the Hand
 |
American Society for Surgery of the Hand assh.org
The Best Resource For Your Hands, Period.
|