ePlasty: Vol. 19
Drummer's Thumb: Ulnar Digital Artery Thrombosis and Aneurismal Change From Repetitive Drumstick Trauma After Carpal-Metacarpal Arthroplasty
Michael R. Ruebhausen, MD, and Nada N. Berry, MD

Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield


Correspondence: mruebhausen@siumed.edu
Keywords: arterial thrombosis, hypothenar hammer, CMC arthroplasty, drummer, repetitive trauma

CASE DESCRIPTION

A 60-year-old man presented for evaluation of new-onset thumb pain 4 months after trapeziectomy and carpal-metacarpal (CMC) arthroplasty with suspensionplasty. His primary complaint was a palpable, painful nodule at the ulnar base of the thumb. He experienced occasional shooting pain to the tip of the thumb while playing drums, as he was a semiprofessional drummer. Magnetic resonance imaging (MRI) was ordered, which showed only local soft tissue reaction, likely consistent with scar tissue or local thickening (Fig 1). Surgical exploration revealed a thrombosed corkscrew ulnar digital artery (Fig 2) similar to vessel appearance in hypothenar hammer syndrome (HHS). A digital Allen's test was performed,1 which demonstrated vascular patency to the thumb. Excision without reconstruction was elected at this time. The segment that was resected was sent for permanent pathology in formalin (Fig 3). The patient reported symptomatic relief, i .......