American Journal of Industrial Medicine. Vol. 56, Iss. 11, November 2013
Hypothenar hammer syndrome: A multicenter case–control study
Riassunto
Background The rarely diagnosed hypothenar hammer syndrome (HHS) is due to vascular damage to the distal part of the ulnar artery probably caused by acute or repetitive blunt trauma to the hypothenar region. To date, mainly case reports have been published, while epidemiological data are almost absent.
Aim To identify potential risk factors for HHS.
Method An interview-based multicenter case–control study of 71 patients with HHS and 105 matched controls was conducted with standardized questions regarding disease specific variables, occupation, exposure of the hands to different types of trauma in occupational and leisure context. Medical data were verified from individual medical records.
Results Multivariable logistic regression analysis revealed that using the hand as a hammer on a daily basis (adjusted odds ratio [aOR] 17.04, 95% CI 5.51–52.67) daily pressure to the palm of the hand (aOR 4.96, 95% CI 1.39–17.71), and daily exposure to vibrating tools (aOR 3.41, 95% CI 1.03–11.31) were significant risk factors for HHS.
Conclusions This investigation represents one of the largest groups of patients with HHS described so far. Work-related repeated blunt trauma to the palm of the hand significantly increases the risk of HHS.
Commento
Il termine “sindrome del martello ipotenare” è stato proposto, per la prima volta, da Conn e collaboratori nel 1970 e si riferisce ad una rara sindrome da insufficienza vascolare cronica della mano, provocata in genere da una occlusione, stenosi o aneurisma della porzione distale dell’arteria ulnare e che tende a manifestarsi, dal punto di vista sintomatologico, come fenomeno di Raynaud asimmetrico o come ischemia acuta di 1 o più dita.
La sindrome coinvolge quasi sempre la mano dominante ed è stata associata, in alcuni studi, a traumatismi ripetitivi del palmo. La maggior parte dei risultati provengono tuttavia da “case-report” e la letteratura è, ad oggi, povera di studi epidemiologici che possano fornire risultati statistici circa l’eziologia professionale della patologia.
La presente ricerca, realizzata da Scharnbacher e collaboratori in Germania, rappresenta uno dei più grandi studi caso-controllo realizzati a livello nazionale sull’argomento e si propone di identificare i principali fattori di rischio professionali correlati con lo sviluppo di questa sindrome.
Keywords
etiology, hand trauma, hypothenar hammer syndrome, occupational, Raynaud's phenomenon, risk factorsArticoli correlati che potrebbero interessarti
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