case_images: PMC6337690_01
case_images: Preoperative angiogram of the right upper extremity showing complete occlusion of the ulnar artery.
case_images: eplasty19ic04_fig1.jpg
case_images: PMC6337690_01_eplasty19ic04_fig1.jpg
case_images: F1
case_images: 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).
case_images: Lateral circumflex femoral arterial graft inset intraoperatively, measuring approximately 14 cm in length.
case_images: eplasty19ic04_fig2.jpg
case_images: PMC6337690_01_eplasty19ic04_fig2.jpg
case_images: F2
case_images: 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. 
case_images: A close-up view of the reconstructed superficial palmar arch utilizing distal branches of the descending lateral circumflex femoral artery.
case_images: eplasty19ic04_fig3.jpg
case_images: PMC6337690_01_eplasty19ic04_fig3.jpg
case_images: F3
case_images: Adequate pulsatile flow was achieved though the graft and confirmed with Doppler ultrasound to each finger (Figs 2 and 3, Video 1).
case_images: 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.
case_images: eplasty19ic04_fig4.jpg
case_images: PMC6337690_01_eplasty19ic04_fig4.jpg
case_images: F4
case_images: 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. 