{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T14:57:52Z","timestamp":1775833072104,"version":"3.50.1"},"reference-count":17,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,8,27]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>A 56-year-old truck driver with a history of tobacco use presented with acute onset digital ischaemia in the ulnar distribution of his dominant hand, associated with severe pain. Occupational exposures included extensive manual labour and prolonged vibratory stimuli. Workup with Doppler and angiography confirmed the diagnosis of hypothenar hammer syndrome (HHS). After the failure of medical management, he underwent ulnar artery thrombectomy with reconstruction and arterial bypass grafting. His pain improved significantly postsurgically, and he was able to return to a normal routine. This case illustrates the classic presentation, examination, imaging findings and management options of HHS. HHS should be considered in patients with digital ischaemia and associated occupational exposures. Diagnosing the condition appropriately allows for optimal management, aiming at minimising symptoms and maximising quality of life.<\/jats:p>","DOI":"10.1136\/bcr-2019-230963","type":"journal-article","created":{"date-parts":[[2019,9,13]],"date-time":"2019-09-13T04:55:30Z","timestamp":1568350530000},"page":"e230963","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Diagnosis of hypothenar hammer syndrome in a patient with acute ulnar artery occlusion"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8495-8579","authenticated-orcid":false,"given":"Frederique","family":"St-Pierre","sequence":"first","affiliation":[{"name":"Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger F","family":"Shepherd","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7246-9324","authenticated-orcid":false,"given":"Matthew Asher","family":"Bartlett","sequence":"additional","affiliation":[{"name":"Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,9,12]]},"reference":[{"key":"2025082711420371000_12.9.e230963.1","unstructured":"World Health Organization. WHO Guidelines Approved by the Guidelines Review Committee, in WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy. Geneva: World Health Organization, 2010."},{"key":"2025082711420371000_12.9.e230963.2","unstructured":"Barshes NR . Overview of upper extremity peripheral artery disease. 2019 https:\/\/http:\/\/www.uptodate.com\/contents\/overview-of-upper-extremity-peripheral-artery-disease?search=ulnar arteryocclusion&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 (Accessed 3 Mar 2019)."},{"key":"2025082711420371000_12.9.e230963.3","unstructured":"Eskandari MK . Upper-Extremity Arterial Occlusive Disease. 2019 October 25. 2018 https:\/\/reference.medscape.com\/article\/462289-overview (Accessed 3 Mar 2019)."},{"key":"2025082711420371000_12.9.e230963.4","first-page":"190","article-title":"[Progress in diagnosis and therapy of thoracic outlet syndrome]","volume":"32","author":"Xiang","year":"2019","journal-title":"Zhongguo Gu Shang"},{"key":"2025082711420371000_12.9.e230963.5","doi-asserted-by":"crossref","first-page":"86","DOI":"10.3390\/jcm7040086","article-title":"Quadrilateral space syndrome: diagnosis and clinical management","volume":"7","author":"Hangge","year":"2018","journal-title":"J Clin Med"},{"key":"2025082711420371000_12.9.e230963.6","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.2008.775"},{"key":"2025082711420371000_12.9.e230963.7","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1024\/0301-1526\/a000371","article-title":"Thromboangiitis obliterans (Buerger\u2019s disease)","volume":"43","author":"Klein-Weigel","year":"2014","journal-title":"Vasa"},{"key":"2025082711420371000_12.9.e230963.8","doi-asserted-by":"publisher","DOI":"10.1024\/0301-1526.37.1.19"},{"key":"2025082711420371000_12.9.e230963.9","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.hcl.2014.09.005","article-title":"Current options for treatment of hypothenar hammer syndrome","volume":"31","author":"Hui-Chou","year":"2015","journal-title":"Hand Clin"},{"key":"2025082711420371000_12.9.e230963.10","first-page":"1122","article-title":"Hypothenar hammer syndrome: posttraumatic digital ischemia","volume":"68","author":"Conn","year":"1970","journal-title":"Surgery"},{"key":"2025082711420371000_12.9.e230963.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2012.11.100"},{"key":"2025082711420371000_12.9.e230963.12","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31820859e1"},{"key":"2025082711420371000_12.9.e230963.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(00)70072-3"},{"key":"2025082711420371000_12.9.e230963.14","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1016\/j.jvs.2009.07.076","article-title":"Prevalence, risk factors, and clinical correlates of ulnar artery occlusion in the general population","volume":"50","author":"Carpentier","year":"2009","journal-title":"J Vasc Surg"},{"key":"2025082711420371000_12.9.e230963.15","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(93)90240-G"},{"key":"2025082711420371000_12.9.e230963.16","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/SAP.0000000000000562","article-title":"Hypothenar hammer syndrome: long-term results after vascular reconstruction","volume":"76","author":"Kitzinger","year":"2016","journal-title":"Ann Plast Surg"},{"key":"2025082711420371000_12.9.e230963.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2015.01.014"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-230963","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:42:08Z","timestamp":1756320128000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-230963"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9]]},"references-count":17,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9,12]]},"published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1136\/bcr-2019-230963"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-230963","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9]]}}}