ePlasty: Vol. 19
Ulnar Artery Reconstruction: Lateral Circumflex Femoral Arterial Graft in the Setting of Hypothenar Hammer Syndrome
Nicholas C. Oleck, BA, Stephen L. Viviano, MD, and Ashley Ignatiuk, MD, MSc, FRCSC

Department of Surgery, Division of Plastic and Reconstructive Surgery, Rutgers New Jersey Medical School, Newark


Correspondence: nco32@njms.rutgers.edu
Keywords: hypothenar hammer syndrome, arterial graft, ulnar hammer syndrome, microsurgery, hand surgery

CASE DESCRIPTION

A 35-year-old left-handed man who works as a mechanic and firefighter presented to our institution with hand pain and cold intolerance for 3 months. He was referred by a local vascular surgeon who had made the diagnosis of hypothenar hammer syndrome (HHS) following an angiogram of the right upper extremity showing complete occlusion of the ulnar artery (Fig 1). On initial examination, Doppler signals of the ulnar artery, superficial palmar arch, and ring/small digital arteries were absent in the right hand. Subsequently, the patient developed an ulcer on his right long fingertip after minor trauma that had not healed over a 4-week period. He suffered ischemic hand pain and severe cold intolerance. After conservative management failed, the decision was made for operative intervention. We proposed using an arterial graft versus a venous graft in order to improve long-term patency. Our plan was to utilize the descending branch of the lateral circumflex .......