At the ROC, we feel very privileged when other surgeons ask us for help with a patient. One such patient was scheduled with Dr. Yevgeny Shuhatovich. Upon his arrival, the patient immediately started his story of frustration, pain and complete disability. He could not use his dominant hand for 1 year. The patient was going from specialist to specialist, ending up on several pain medications and no solution. His stop before ROC was with a vascular surgeon, who had done imaging of the arteries and rightfully noted that one of the arteries (ulnar) was completely occluded and had multiple aneurisms. In addition to these findings, the patient had been an avid smoker and had a rare genetic mutation that made him clot much more than normal. As soon as the patient arrived at ROC, a diagnosis of Hypothenar Hammer Syndrome (HHS) was made.
HHS is a rare syndrome that generally occurs in patients that repetitively use their fist as a hammer, but not always. Patients typically present with severe pain in the small and ring fingers, stemming from lack of blood flow to those digits. The lack of blood flow occurs because these aneurisms collect clot and eventually obliterate the lumen of the blood vessel. These result in lack of blood flow, which in turn results in severe pain, and eventually possible death of the fingers.
This patient needed to have a procedure that restores blood flow to his fingers ASAP. Dr. Shuhatovich performed the surgery by taking a long segment of an artery from the patient’s thigh and routing it from the healthy segment of the clotted forearm artery to the two fingers in order to restore blood flow. The fingers pinked up immediately as the vascular clamps were released and all the members of the surgical team breathed a deep sigh of relief. Upon awakening from anesthesia the patient no longer experienced any pain in the hand.
We followed this patient at ROC for 1 year thereafter. After 3 months, the patient returned to regular work and at 1-year follow-up the patient had an ultrasound of the artery and the graft had excellent blood flow. The patient could not be happier. He has since quite smoking and started going to the gym regularly. He has really turned his life around and we at ROC are very proud of his accomplishments.