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Journal of Hand Surgery (British and European Volume)
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Articles

Surgical Management of Hypothenar and Thenar Hammer Syndromes: A Retrospective Study of 31 Instances in 28 Patients

R. S. M. DETHMERS
P. HOUPT

From the Centre for Plastic, Reconstructive and Handsurgery, Isala Klinieken, Zwolle, The Netherlands

Correspondence: R.S.M. Dethmers, De Schöppe 5, 7609 CA Almelo, The Netherlands. Tel.: +31 546 815220; fax: +31 546 815220. E-mail: rsmdethmers{at}hotmail.com

This retrospective study assessed the results of treatment of 29 cases of hypothenar hammer syndrome and two cases of thenar hammer syndrome. Three hands were symptom free, 15 were improved, 11 were unchanged and two were worse at a mean follow-up of 43 (range 4–60) months. Follow-up colour-coded Duplex sonography of revascularizations (n = 27) revealed 13 patent, five occluded and one partially thrombosed grafts, seven grafts with aneurysmal dilatations and one coiled graft. Colour-coded Duplex sonography results after venous interposition graft combined with endoscopic thoracic sympathectomy were no better than venous interposition graft alone. All three arterial interposition grafts and two end-to-end-reconstructions were patent. The Duplex outcomes of the revascularizations did not correspond well with the clinical outcomes. Endoscopic thoracic sympathectomy was associated with a high rate of inconvenient side effects.

Key Words: arterial interposition graft • colour-coded Duplex sonography • endoscopic thoracic sympathectomy • hypothenar hammer syndrome • thenar hammer syndrome

Journal of Hand Surgery (British and European Volume), Vol. 30, No. 4, 419-423 (2005)
DOI: 10.1016/J.JHSB.2005.02.013
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