We report on two cases of true aneurysms of the palmar arch, both of which were post-traumatic. One was due to repetitive blunt trauma and the other to a glass cut wound.
fibres and smooth muscle in the aneurysm wall proved it to be a true aneurysm. Both aneurysms were excised and teplaced by a vein graft from the foot. Both aneurysms were detected clinically as pulsating 0 1996 Wiley-Liss, Inc.
masses without functional disorders. The presence of elastic MICROSURGERY 17:102-105 1996
True aneurysms of the hand are rare. Yet, once special attention is paid to this disease, considerable case numbers can be collected even in single clinics. Recently, five cases of digital and palmar aneurysms have been reported by our group. Then a few months later, two more interesting cases of true post-traumatic palmar arch aneurysms were detected and operated upon. The essential feature of a true aneurysm consists of the presence of parts of the normal vessel wall in the aneurysm wall.
CASE REPORT 1
A 44-year-old housewife discovered a pulsating mass. in her left palm. She had no history of trauma, but upon enquiry she remembered that she had a habit of emptying her shower gel bottle by striking it forcefully on her left palm. She did not complain of functional damage. Perfusion and sensibility of all fingers were intact. Clinical examination showed a 0.5-mm palpable tumour with slight pulsation. Angiography (Fig. 1) revealed a fusiform aneurysm of the palmar arch just in the bifurcation to the fourth common digital artery. The aneurysm was excised (Fig. 2 ) , and the palmar arch was reconstructed immediately by a y-shaped vein graft from the foot (Fig. 3). Pathological examination (Fig. 4) confirmed the diagnosis to be a true aneurysm with fragmentation of the media, but an intact adventitia.
CASE REPORT 2
A 3 I-year-old man accidentally cut his left palm with a broken glass. The wound was sutured in another clinic, since neither considereable haemorrhage nor loss of sensi-From the Clinic for Plastic, Hand, and Reconstructive Surgery (B.