PMC6337690_01
Preoperative angiogram of the right upper extremity showing complete occlusion of the ulnar artery.
eplasty19ic04_fig1.jpg
PMC6337690_01_eplasty19ic04_fig1.jpg
F1
He was referred by a local vascular surgeon who had made the diagnosis of hypothenar hammer syndrome (HHS) following an angiogram of the right upper extremity showing complete occlusion of the ulnar artery (Fig 1). Adequate pulsatile flow was achieved though the graft and confirmed with Doppler ultrasound to each finger (Figs 2 and 3, Video 1).
Lateral circumflex femoral arterial graft inset intraoperatively, measuring approximately 14 cm in length.
eplasty19ic04_fig2.jpg
PMC6337690_01_eplasty19ic04_fig2.jpg
F2
Adequate pulsatile flow was achieved though the graft and confirmed with Doppler ultrasound to each finger (Figs 2 and 3, Video 1). Doppler signals remained strong and the ulcer previously present on the right long fingertip had completely resolved (Fig 4, Video 2). During this visit he reported to be asymptomatic and has had complete resolution of the cold intolerance and burning pain of his right hand. 
A close-up view of the reconstructed superficial palmar arch utilizing distal branches of the descending lateral circumflex femoral artery.
eplasty19ic04_fig3.jpg
PMC6337690_01_eplasty19ic04_fig3.jpg
F3
Adequate pulsatile flow was achieved though the graft and confirmed with Doppler ultrasound to each finger (Figs 2 and 3, Video 1).
Preoperative image depicting ulceration of the tip of the right long finger (left). Postoperative image of the same site which has now healed, 1 month out from surgery following ulnar arterial reconstruction.
eplasty19ic04_fig4.jpg
PMC6337690_01_eplasty19ic04_fig4.jpg
F4
Doppler signals remained strong and the ulcer previously present on the right long fingertip had completely resolved (Fig 4, Video 2). During this visit he reported to be asymptomatic and has had complete resolution of the cold intolerance and burning pain of his right hand. 