HYPOTHENAR HAMMER SYNDROME SUCCESSFULLY MANAGED WITH INTRAVENOUS PROSTAGLANDIN-E1 AND HEPARIN AND WITH CORRECTION OF THE THROMBOGENIC RISK PROFILE - A CASE-REPORT

A fifty-one-year-old man presented with a history, symptoms, and clini cal findings typical of a hypothenar hammer syndrome in his dominant h and. A thrombotic obstruction in the distal section of the ulnar arter y with multiple downstream occlusions of proper digital arteries were documented angiographically. Coexistence of additional cardiovascular risk factors (smoking-induced polycythemia, obesity, hypercholesterole mia, and hypertension) was identified. Conservative management with in travenous heparin and prostaglandin E1 together with measures directed at controlling the additional risk factors (repeated venesection, imm ediate smoking cessation, and low-lipid diet) resulted in a striking c linical and angiographic improvement of the digital perfusion, without resort to interventional measures or thrombolysis.