Trans-scaphoid and trans-capitate perilunate fracture-dislocation of the wrist with concomitant ipsilateral fractures: a case report

All perilunate fracture-dislocations combine bone avulsions, ligament disruption and fractures in different forms. The most frequent pattern is the dorsal transscaphoid perilunate fracture-dislocation. The reported risk of missed initial diagnosis in perilunate dislocations is as high as 20%. Concerning pathomechanics of the perilunate fracture-dislocation, it should be noted that most dorsal injuries usually result from a fall on the outstretched hand or motor vehicle accidents although other mechanisms are also mentioned. We describe here a case of dorsal trans-scaphoid trans-capitate perilunate fracture-dislocation together with posterior olecranon fracture-dislocation of the left upper extremity. To the best of the authors' knowledge, such a case with this concomitant elbow fracture-dislocation has not been previously reported in the literature

Enchondroma of the hand: the role of biopsy in the course of diagnosis and treatment

Enchondroma is the most frequent bone tumor of the hand, but chondrosarcoma is rare at this location. There is a high possibility of correct diagnosis of enchondroma and differentiating from its malignant counterpart by precise clinical and radiologic assessment without biopsy, a subject of debate in the literature. At the present study we substantially investigate this problem, in our patients. Case records, radiographs, and histology of 52 solitary enchondroma patients who underwent operation in our hospital between 1998 and 2010, were reviewed. Special attention paid to pre and post -op diagnoses, and compared with each other. Eighty-six percent of our patients were between the second to fourth decades of life, with a slight female predominance. In all, the primary diagnosis of enchondroma according to clinical presentation and radi-ographic appearance, supported by intraoperative gross appearance of tumor, and confirmed histologically by permanent section analysis. There was no mismatch between radiologic and histologic diagnosis. we concluded that correct diagnosis of enchondroma is almost always possible by precise clinical and radiographic assessment with no need for histologic confirmation before definitive treatment