Vayssairat M, Debure C, Cormier J M, Bruneval P, Laurian C, Juillet Y
J Vasc Surg. 1987 Jun;5(6):838-43.
Hypothenar hammer syndrome is a rare and often incorrectly diagnosed form of secondary Raynaud's phenomenon in workers who use their hand as a hammer. We report 17 documented cases with long-term follow-up after diagnosis made on the basis of arteriography. Clinical findings include male sex, unilaterality, sudden onset, and severe Raynaud's phenomenon. Angiography indicated that the 17 patients had either ulnar thrombosis or ulnar aneurysm; most of them also had embolic occlusions of the digital arteries. Main pathologic findings were thrombosis on the intima and fibrosis in the media. We adopted a surgical procedure consisting of resection with end-to-end reconstruction for patent aneurysms to avoid downstream emboli and more conservative treatment when the ulnar artery was thrombosed. No patient required digital amputation and all except one improved and were able to live and work normally with only a moderate disability, consisting of Raynaud's phenomenon during the cold season only.
小鱼际锤状指综合征是一种罕见的、常被误诊的继发性雷诺现象，多见于以手为锤劳作的工人。我们报告17例经动脉造影确诊并长期随访的病例。临床表现包括男性、单侧发病、起病突然及严重的雷诺现象。血管造影显示17例患者存在尺动脉血栓形成或尺动脉瘤；多数患者还伴有指动脉栓塞性闭塞。主要病理表现为内膜血栓形成和中膜纤维化。对于有症状的动脉瘤，我们采用切除并端端重建的手术方法以避免下游栓子形成，而当尺动脉血栓形成时则采取更保守的治疗。无一例患者需要截指，除1例患者外，其余患者均有改善，仅在寒冷季节出现轻度雷诺现象，能够正常生活和工作，仅有中度残疾。
