Thenar and hypothenar hammer syndromes with Raynaud’s phenomenon can be successfully treated with an iloprost injection course, according to a case study by a team of researchers from Wales and Italy.
The study, “Combined Thenar and Hypothenar Hammer Syndromes and Raynaud’s Phenomenon Successfully Treated with Iloprost,” was published in the journal Case Reports in Rheumatology.
Thenar and hypothenar eminences (muscle groups in the palm of hand) control finger movements.
The study reported the case of a 53-year-old carpenter who had cold white fingers on his right hand. He also had Raynaud’s phenomenon. Although the symptoms lasted a short time, they became increasingly more persistent and appeared mostly following intensive periods of work that required using his hand. He had no family history of cardiovascular disease.
A CT scan of the man’s hand showed decreased blood flow in his third finger artery. Additional CT scans of his right arm revealed an obstruction in his forearm artery at the level of his thenar and hypothenar muscle groups and no distal circulation in the arm.
Iloprost is a drug used to treat pulmonary arterial hypertension (PAH), scleroderma, Raynaud’s phenomenon, and other conditions involving constricted blood vessels and blood flow obstruction. The drug works as a vasodilator to widen blood vessels, allowing blood to pass through.
Following treatment with iloprost injection, the patient experienced significant improvements. A CT scan repeated three months later showed that blood flow in the arteries was re-established.
Only four other reports (detailing six patient cases) have been recorded that describe the presence of simultaneous hypothenar and thenar hammer syndrome.
The researchers suggest that simultaneous thenar and hypothenar hammer syndromes should be considered in cases when restriction in blood supply occurs in the fingers of one hand, especially in men who use their dominant hand to hammer or in intense hammer-type motions. If patients are diagnosed properly they can be treated easily with a short course of iloprost.