"In the past, treatment of hypothenar hammer syndrome has been controversial, and physicians have been searching for some way to treat it," says Craig Johnson, M.D., chair of Mayo Clinic's Division of Plastic Surgery and lead study investigator. "From our study, it's clear that people with this syndrome shouldn't be treated with medication or other treatments, but with surgery."

Dr. Johnson explains that symptoms improved in 78 percent of the patients in his study who underwent a bypass grafting operation and that he witnesses an almost immediate relief in his patients with this surgery.

"Post-surgery, patients feel their hands are warmer right away, though ulcers take a little longer to heal," he says. "Most people do quite well and get back to work quickly."

Patients with this condition have a damaged ulnar artery, a key means of blood flow to the hand. In addition to the sensory damage, they also can develop small ulcers in their fingertips resulting in blackened fingers or even gangrene, due to lack of oxygenation.

"Many times they can't do their jobs due to pain," says Dr. Johnson. "They have cold intolerance, so often they can't go outside when it's cold or handle anything chilled, like cold meat. They also can't hold heavy objects."

The treatment found to improve these symptoms, bypass grafting surgery, involves removing the damaged portion of the artery, which Dr. Johnson describes as clotted much like a clogged lead pipe. The artery's blood flow is then restored by replacing the section of blocked artery with a vein graft.

In this study, Dr. Johnson studied 115 hands in 101 patients evaluated at Mayo Clinic. Medical and surgical treatment options pursued wer
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Contact: Lisa Lucier
newsbureau@mayo.edu
507-284-5005
Mayo Clinic
11-May-2005