Hypothenar Hammer Syndrome: A Systematic Review and Meta-Analysis of Patency Rates and Patient-Reported Outcome Measures.
Louis Massoud, Emily H Chestnut, Joshua M Adkinson et al.
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In 30 seconds
This systematic review and meta-analysis assessed long-term patency and patient-reported outcomes after surgical treatment of hypothenar hammer syndrome, comparing vein grafts, arterial grafts, and direct repair. Fourteen publications were included, with 13 reporting patency and five reporting patient-reported outcomes. Pooled patency was 65% for vein grafts and 67% for direct repair; arterial grafts had 100% patency across 4 studies (n = 23; mean follow-up 40.8 months). Longitudinal patency was higher with arterial than vein grafts (β = 0.36, P = .001). DASH scores were similar for vein grafts and direct repair.
Key findings
- Pooled patency was 65% for vein grafts, with a yearly rate decline of 4.4% (P = .243).
- Arterial graft patency was 100% across 4 studies (n = 23; mean follow-up 40.8 months); longitudinal patency exceeded that of vein grafts (β = 0.36, P = .001).
- Pooled patency for direct repair was 67%.
- DASH scores were comparable for vein grafts and direct repair (10.9 vs. 11.5; P = .958).
Why it matters
Surgical options for hypothenar hammer syndrome differ in reported long-term vessel patency, while functional outcomes appear similar between vein grafting and direct repair. These pooled findings help frame the trade-off between maintaining arterial patency and postoperative patient-reported function, while highlighting that the evidence comes from a limited set of publications.
What to keep in mind
The review included only 14 publications, and the arterial-graft estimate was based on 4 studies and n = 23. The abstract does not report pooled sample sizes for the other comparisons.