ABSTRACT
Distal phalangeal fractures are the most common fractures of the hand but nonunions are unusual in the distal phalanx. Eleven patients were operated on for nonunions of the distal phalanx. The diagnosis of nonunion was made by the presence of the clinical (pain, deformity, instability) and radiological signs of nonunion more than 4 months after the initial injury. Three patients had developed infection and four of them had bone resorption after their initial treatments, which probably caused nonunion. Olecranon bone grafting combined with Kirschner wire fixation was done in all patients. The mean follow up was 7 months (range 5-18 months). There were no major complications at the donor or recipient sites. One patient had a haematoma formation at the donor site. There was complete radiological union of bone-grafted sites in all patients except one. There were no cases of pain, deformity, or instability after the treatment. The olecranon bone graft was found to be safe and easy to harvest. Its strong tubular structure replaced the distal phalanx successfully.
Subject(s)
Bone Transplantation , Finger Phalanges/injuries , Fracture Fixation, Internal/methods , Fractures, Ununited/surgery , Olecranon Process/transplantation , Adult , Bone Wires , Cohort Studies , Female , Fracture Healing , Fractures, Ununited/diagnosis , Fractures, Ununited/etiology , Humans , Male , Middle Aged , Retrospective Studies , Treatment OutcomeABSTRACT
Tenosynovial giant cell tumours originate from synovial tissues of the joints, tendon sheaths, mucosal bursas or fibrous tissues adjacent to tendons. Tenosynovial giant cell tumours are rarely intra-articular. We report a giant cell tumour of the tendon sheath arising from the posterior cruciate ligament diagnosed by magnetic resonance imaging and resected arthroscopically in a 54-year-old woman.
Subject(s)
Arthroscopy/methods , Giant Cell Tumors/diagnosis , Giant Cell Tumors/surgery , Posterior Cruciate Ligament/pathology , Female , Humans , Magnetic Resonance Imaging/methods , Middle Aged , Pigmentation , Posterior Cruciate Ligament/surgery , Tendons/pathology , Tenosynovitis/diagnosis , Treatment OutcomeABSTRACT
AIM: To investigate in fractures of the fifth metacarpal neck whether there is any difference in functional results of non-operative treatments with dorsal angulation either below or above 30 degrees. METHODS: After closed reduction, fractures were treated with plaster splints for 5 weeks. Cases were divided into two groups, with dorsal angulation either below (group 1) or above (group 2) 30 degrees, according to oblique radiography, and were evaluated at 6 months. Grip strength, range of passive joint movement and distance from fingertip to distal crease were measured and compared. A scoring system assessed function, and occupational adequacy, patient satisfaction and presence of pain were recorded. RESULTS: Functional outcome was good or very good in both groups and occupational adequacy was not reduced in any case. Full patient satisfaction was achieved except for one person in group 1 and two people in group 2, regarding cosmetic results. There was no statistically significant difference between the two hands in either group except for one man from group 2, who had mild pain during coercive use of the injured hand. CONCLUSIONS: With non-operative treatment of fractures of the neck of the fifth metacarpal, similar results were achieved with dorsal angulation either above or below 30 degrees. A dorsal angulation less than 45 degrees may be treated conservatively.
