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Vascular Injury, Wrist and Hand
Carol L. Andrews, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Hypothenar hammer syndrome (HHS): Ulnar artery superficial palmar arch injury; related to repetitive trauma to heel of hand, ± associated ulnar artery pseudoaneurysm
            • Pseudoaneurysm: Saccular cystic dilatation of artery related to disruption of intima + media with hematoma; contained by adventitia
            • Vessel laceration: Complete or partial disruption of vessel, typically from penetrating trauma

          IMAGING

          • General Features

            • Radiographic Findings

              • Angiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Relevant Anatomy

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        Selected References

                                        1. Poole CJ et al: Vascular hand-arm vibration syndrome-magnetic resonance angiography. Occup Med (Lond). 66(1):75-8, 2016
                                        2. de Mooij T et al: Vascular injuries in the upper extremity in athletes. Hand Clin. 31(1):39-52, 2015
                                        3. Iannuzzi NP et al: Acute Arterial Thrombosis of the Hand. J Hand Surg Am. 40(10):2099-106, 2015
                                        4. Lisle DA et al: MR imaging of traumatic and overuse injuries of the wrist and hand in athletes. Magn Reson Imaging Clin N Am. 17(4):639-54, vi, 2009
                                        5. Ablett CT et al: Hypothenar hammer syndrome: case reports and brief review. Clin Med Res. 6(1):3-8, 2008
                                        6. McCready RA et al: Combined thenar and hypothenar hammer syndromes: case report and review of the literature. J Vasc Surg. 48(3):741-4, 2008
                                        7. Soubeyrand M et al: Penetrating volar injuries of the hand: diagnostic accuracy of US in depicting soft-tissue lesions. Radiology. 249(1):228-35, 2008
                                        8. Stepansky F et al: Dynamic MR angiography of upper extremity vascular disease: pictorial review. Radiographics. 28(1):e28, 2008
                                        9. Youakim S: Thenar hammer syndrome: a case report. Occup Med (Lond). 56(7):507-9, 2006
                                        10. Dethmers RS et al: Surgical management of hypothenar and thenar hammer syndromes: a retrospective study of 31 instances in 28 patients. J Hand Surg Br. 30(4):419-23, 2005
                                        11. Ginn TA et al: Vascular changes of the hand in professional baseball players with emphasis on digital ischemia in catchers. J Bone Joint Surg Am. 87(7):1464-9, 2005
                                        12. Rosner JL et al: Imaging of athletic wrist and hand injuries. Semin Musculoskelet Radiol. 8(1):57-79, 2004
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Definitions

                                                  • Hypothenar hammer syndrome (HHS): Ulnar artery superficial palmar arch injury; related to repetitive trauma to heel of hand, ± associated ulnar artery pseudoaneurysm
                                                  • Pseudoaneurysm: Saccular cystic dilatation of artery related to disruption of intima + media with hematoma; contained by adventitia
                                                  • Vessel laceration: Complete or partial disruption of vessel, typically from penetrating trauma

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • Angiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Relevant Anatomy

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              Selected References

                                                                              1. Poole CJ et al: Vascular hand-arm vibration syndrome-magnetic resonance angiography. Occup Med (Lond). 66(1):75-8, 2016
                                                                              2. de Mooij T et al: Vascular injuries in the upper extremity in athletes. Hand Clin. 31(1):39-52, 2015
                                                                              3. Iannuzzi NP et al: Acute Arterial Thrombosis of the Hand. J Hand Surg Am. 40(10):2099-106, 2015
                                                                              4. Lisle DA et al: MR imaging of traumatic and overuse injuries of the wrist and hand in athletes. Magn Reson Imaging Clin N Am. 17(4):639-54, vi, 2009
                                                                              5. Ablett CT et al: Hypothenar hammer syndrome: case reports and brief review. Clin Med Res. 6(1):3-8, 2008
                                                                              6. McCready RA et al: Combined thenar and hypothenar hammer syndromes: case report and review of the literature. J Vasc Surg. 48(3):741-4, 2008
                                                                              7. Soubeyrand M et al: Penetrating volar injuries of the hand: diagnostic accuracy of US in depicting soft-tissue lesions. Radiology. 249(1):228-35, 2008
                                                                              8. Stepansky F et al: Dynamic MR angiography of upper extremity vascular disease: pictorial review. Radiographics. 28(1):e28, 2008
                                                                              9. Youakim S: Thenar hammer syndrome: a case report. Occup Med (Lond). 56(7):507-9, 2006
                                                                              10. Dethmers RS et al: Surgical management of hypothenar and thenar hammer syndromes: a retrospective study of 31 instances in 28 patients. J Hand Surg Br. 30(4):419-23, 2005
                                                                              11. Ginn TA et al: Vascular changes of the hand in professional baseball players with emphasis on digital ischemia in catchers. J Bone Joint Surg Am. 87(7):1464-9, 2005
                                                                              12. Rosner JL et al: Imaging of athletic wrist and hand injuries. Semin Musculoskelet Radiol. 8(1):57-79, 2004