Preview

Regional blood circulation and microcirculation

Advanced search

A clinical case of successful surgical treatment of a posttraumatic false aneurysm of the ulnar artery as a manifestation of hypothenar hammer syndrome in a young patient

https://doi.org/10.24884/1682-6655-2023-22-4-87-94

Abstract

We present a case of a successful surgical treatment of posttraumatic false aneurysm of the left ulnar artery in a young patient with hypothenar hammer syndrome (HHS). Patient I., 22 years old, was admitted to the Clinic of Vascular Surgery with complaints of a throbbing painful mass on the palmar surface of the left hand. The patient was known to have a posttraumatic thrombophlebitis of the trunk and tributaries of the great saphenous vein of the right shin with incomplete recanalization of the lumen of unknown age and also he suffers from varicose veins of both lower limbs. The diagnoses were confirmed by ultrasound examination. The patient was examined and the results revealed an aneurysmal dilatation of the left ulnar artery in the wrist with a maximal diameter of 6.5 mm, the indication for surgical treatment were determined. On February 09, 2023, a surgical intervention was performed: aneurysm resection followed by ulnar artery replacement with a reversed аutologous vein. The clinical interest of the observation lies in the rare occurrence of this syndrome among patients, technical complexity of the operation due to anatomical features of the aneurysm location, as well as the use of microsurgical techniques during surgical treatment. The use of angiographic control made it possible to timely eliminate the pronounced vasospasm that developed immediately after starting the blood flow through the reconstructed section of the arterial bed. The result of the intervention was a complete relief of pain and pulsation in the left hand in the early postoperative period.

About the Authors

К. P. Moiseev
Almazov National Medical Research Centre
Russian Federation

Moiseev Konstantin P. – Intern, Attending Physician, Department of Cardiovascular Surgery

Saint Petersburg



A. S. Sultayev
North-Western State Medical University named after I. I. Mechnikov
Russian Federation

Sultayev Akhmed S. – Intern, Attending Physician, Depart- ment of Cardiovascular Surgery

Saint Petersburg



A. V. Kebriakov
North-Western district scientific and clinical center named after L. G. Sokolov Federal Medical and Biological Agency
Russian Federation

Kebriakov Aleksei V. – cardiovascular surgeon

Saint Petersburg



T. K. Gamzatov
North-Western district scientific and clinical center named after L. G. Sokolov Federal Medical and Biological Agency
Russian Federation

Gamzatov Temirlan K. – Candidate of Medical Sciences (PhD), Cardiovascular Surgeon

Saint Petersburg



A. V. Svetlikov
North-Western district scientific and clinical center named after L. G. Sokolov Federal Medical and Biological Agency
Russian Federation

Svetlikov Aleksei V. – MD, head, Department of Vascular and Endovascular Surgery

Saint Petersburg



References

1. Clinical Angiology: Manual / ed. by A.V. Pokrovsky. In two volumes. Vol. 2. Moscow, Meditsina, 2004:888. (in Russ.).

2. Falk PS, Scuderi PE, Sherertz RJ, Motsinger SM. Infected radial artery pseudoaneurysms occurring after percutaneous cannulation. Chest. 1992;101(2):490-495. Doi: 10. 1378/chest.101.2.490.

3. Safeek RH, O’Toole A, Furtado WR, Wilhemi BJ, Choo JH. Isolated Ulnar Artery Injury: Indications for and Timing of Operative Intervention. Eplasty. 2022;22:e37.

4. Cotroneo A, Barillà D, Armient F, Martinelli GL, Diena M. Distal Ulnar Artery Aneurysm Repair by End-to-End Technique: A Case Report. Ann Vasc Surg. 2018;46:367.e15–367. e17. Doi: 10.1016/j.avsg.2017.07.025.

5. Orrapin S, Arworn S, Wisetborisut A. Unusual Cases of Hypothenar Hammer Syndrome. Ann Vasc Dis. 2015;8(3):262264. Doi: 10.3400/avd.cr.15-00053.

6. Odajima R, Nishimoto S, Kawai K, Ishise H, Kakibuchi M. A traumatic ulnar artery aneurysm in an infant. J Sure Case Rep. 2021;(4):rjab098. Doi: 10.1093/jscr/rjab098.

7. Abdulla KA, Kamal DM, Mathew KP. Idiopathic true ulnar artery aneurysm. 2021;81:105821. Doi: 10.1016/j.ijscr. 2021.105821.

8. Hui-Chou HG, McClinton MA. Current Options for Treatment of Hypothenar Hammer Syndrome. Hand Clin. 2015;31(1):53-62. Doi: 10.1016/j.hcl.2014.09.005.

9. Ravari H, Johari HG, Rajabnejad A. Hypothenar Hammer Syndrome: Surgical Approach in Patients Presenting with Ulnar Artery Aneurysm. Ann Vasc Surg. 2018;50:284-287. Doi: 10.1016/j.avsg.2017.11.047.

10. Onur-Beyaz M, Demir I, Can-Ata Е. Upper extremıty arterıal aneurysms: Etıology, management, and outcome. Cir Cir. 2022;90(4):481-486. Doi: 10.24875/ciru.21000068.

11. Moradi A, Hajian A. Presentation of the hypothenar hammer syndrome as a low incidence aneurysmal disorder of the ulnar artery. Int J Surg Case Rep. 2021:85:106200. Doi: 10.1016/j.ijscr.2021.106200.

12. de Queiroz MMM, Pereira LP, Picanço СG, Luna RC, Costa FS, Silveira CRS. Síndrome do martelo hipotenar: relato de caso e revisão da literature. Hypothenar Hammer Syndrome: Case Report and Literature Review. Revista Brasileira de Ortopedia. 2013;48(1):104-107. Doi: 10.1016/j.rbo. 2012.10.004.

13. Kumar Y, Hooda K, Lo L, Karol I. Ulnar artery aneurysm and hypothenar hammer syndrome. BMJ Case Rep. 2015;2015:bcr2015211444. Doi: 10.1136/bcr-2015-211444.

14. Zhang F, Weerakkody Y, Tosenovsky P. Hypothenar hammer syndrome in an office worker. J Med Imag Radiat Oncol. 2017;61(6):774-776. Doi: 10.1111/1754-9485.12651.

15. Swofford BP, Swofford DP. Management of Hypothenar Hammer Syndrome A Case Report. Am J Case Rep. 2018;19:150-152. Doi: 10.12659/ajcr.906849.

16. Jud P, Pregartner G, Berghold A, Rief1 P, Muster V, Gütl K, Brodmann M, Hafner F. Endovascular Thrombolysis in Hypothenar Hammer Syndrome: A Systematic Review. Front Cardiovasc Med. 2021;8:745776. Doi: 10.3389/ fcvm.2021.745776.

17. Dethmers RSM, Houpt P. Surgical management of hypothenar and thenar hammer syndromes: a retrospective study of 31 instances in 28 patients. J Hand Surg Br. 2005;30(4):419423. Doi: 10.1016/j.jhsb.2005.02.013.

18. Carr MP, Becker GW, Taljanovic MS, McCurdy WE. Hypothenar hammer syndrome: Case report and literature review. Radiol Case Rep. 2019;14(7):868-871. Doi: 10.1016/j.radcr.2019.04.015.

19. Ferris BL, Taylor LM, Oyama K, McLafferty RB, Edwards JM, Moneta GL, Porter JM. Hypothenar hammer syndrome: Proposed etiology. J Vasc Surg. 2000;31(1):104-113. Doi: 10.1016/s0741-5214(00)70072-3.

20. Masden DL, Seruya M, Higgins JP. A Systematic Review of the Outcomes of Distal Upper Extremity Bypass Surgery With Arterial and Venous Conduits. J Hand Surg. 2012; 37(11):2362–2367. Doi: 10.1016/j.jhsa.2012.07.028.


Review

For citations:


Moiseev К.P., Sultayev A.S., Kebriakov A.V., Gamzatov T.K., Svetlikov A.V. A clinical case of successful surgical treatment of a posttraumatic false aneurysm of the ulnar artery as a manifestation of hypothenar hammer syndrome in a young patient. Regional blood circulation and microcirculation. 2023;22(4):87-94. (In Russ.) https://doi.org/10.24884/1682-6655-2023-22-4-87-94

Views: 390


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1682-6655 (Print)
ISSN 2712-9756 (Online)