HAND-ARM VIBRATION SYNDROME WITH PROXIMAL ULNAR ARTERY-OCCLUSION

The case of a man exposed during 25 years to vibration while maneuveri ng a heavy earth moving tractor is reported. The first clinical manife station of hand-arm vibration syndrome was a bilateral Raynaud's pheno menon followed five years later by digital necrosis. The arteriography revealed a proximal and bilateral ulnar artery occlusion. Bilateral m edian nerve conduction abnormalities were also present. Vibration expo sure level was much higher than the threshold level proposed by the Eu ropean Commission. Laboratory were all negative. The purpose of this r eport is to show that vibration can be responsible for proximal occlus ion of a medium sized artery and severe neurovascular abnormalities wh ich must be distinguished from the usual vasospastic Raynaud's phenome non and the classical hypothenar hammer syndrome. An early and correct diagnosis is crucial because continued repetitive trauma can result i n irreversible ischemic injury and loss of digits.