A clinical case of successful surgical treatment of a posttraumatic false aneurysm of the ulnar artery as a manifestation of hypothenar hammer syndrome in a young patient

Abstract

We present a case of a successful surgical treatment of posttraumatic false aneurysm of the left ulnar artery in a young patient with hypothenar hammer syndrome (HHS). Patient I., 22 years old, was admitted to the Clinic of Vascular Surgery with complaints of a throbbing painful mass on the palmar surface of the left hand. The patient was known to have a posttraumatic thrombophlebitis of the trunk and tributaries of the great saphenous vein of the right shin with incomplete recanalization of the lumen of unknown age and also he suffers from varicose veins of both lower limbs. The diagnoses were confirmed by ultrasound examination. The patient was examined and the results revealed an aneurysmal dilatation of the left ulnar artery in the wrist with a maximal diameter of 6.5 mm, the indication for surgical treatment were determined. On February 09, 2023, a surgical intervention was performed: aneurysm resection followed by ulnar artery replacement with a reversed аutologous vein. The clinical interest of the observation lies in the rare occurrence of this syndrome among patients, technical complexity of the operation due to anatomical features of the aneurysm location, as well as the use of microsurgical techniques during surgical treatment. The use of angiographic control made it possible to timely eliminate the pronounced vasospasm that developed immediately after starting the blood flow through the reconstructed section of the arterial bed. The result of the intervention was a complete relief of pain and pulsation in the left hand in the early postoperative period.