De Faucal P, Planchon B, Dupas B, Dupas A, Geraut P
Médecine interne, Hôtel Dieu, Nantes.
J Mal Vasc. 1991;16(1):9-12.
Three cases of hypothenar hammer syndrome are reported in manual workers who experienced repeated traumatism of the palm of the hand either because of personal habit or the use of professional tools. Hemodynamic examination of the upper limb was performed by plethysmography (Perivein Etna) and Doppler ultrasound (8 MHz) complemented by angiography by direct puncture of the humeral artery. Ultrasonography was performed using a 7.5 MHz probe (Sononranger) for exploration of the ulnar artery at the wrist and in its course through the palm. The 3 patients presented aneurysmal dilatation of the ulnar artery in the palm, complicated by postembolic thrombosis of the collateral arteries of the fingers. The ulnar artery lesion was permeable 1 time, already thrombosed 1 time and thrombosed secondarily 1 time. Ultrasonography of the palm showed suspected aneurysm of the ulnar artery in 2 patients: one case was confirmed by angiography, whereas the other remained only suspect since the thrombosed ulnar artery was not opacified. The third patient presented an ulnar artery thrombosis without true aneurysmal dilatation. It may be concluded that ultrasonography can show suspected aneurysmal dilatation of the ulnar artery and be complementary to arteriography when the ulnar artery is thrombosed.
本文报告了3例小鱼际锤状指综合征病例,患者均为体力劳动者,因个人习惯或使用专业工具导致手掌反复受到创伤。通过体积描记法(Perivein Etna)和多普勒超声(8兆赫)对上肢进行血流动力学检查,并通过直接穿刺肱动脉进行血管造影作为补充。使用7.5兆赫探头(Sononranger)进行超声检查,以探测腕部尺动脉及其在手掌中的走行。3例患者均出现手掌部尺动脉瘤样扩张,并伴有手指侧支动脉栓塞后血栓形成。尺动脉病变1次通畅,1次已形成血栓,1次继发血栓形成。手掌超声检查显示2例患者疑似尺动脉瘤:1例经血管造影证实,另1例仅为疑似,因为血栓形成的尺动脉未显影。第3例患者出现尺动脉血栓形成,无真正的瘤样扩张。可以得出结论,超声检查可显示疑似尺动脉瘤样扩张,在尺动脉血栓形成时可作为血管造影的补充检查。