[An unusual manifestation of osteo-articular, tendinous and nervous involvement secondary to tophaceous gout of the hand. A report of two cases]. / Rare manifestation de lésion ostéoarticulaire, tendineuse et neurologique par goutte tophacée de la main. Deux cas cliniques.

Tophaceous gout of the hand is a rare condition, but possible in chronic cases. We report two cases (three hands) with a long history of hyperuricemia and serious lesions due to deposition of sodium urate crystals. In these cases we point out several fundamental aspects: the abnormal size of the tophi, the destruction of triquetum and pisiform, the digital joint instability due to ligamentous lesions, the tenosynovitis and digital flexion contracture secondary to intratendinous deposition of urates, and the presence of a double ipsilateral tunnel syndrome of the median and ulnar nerves at the wrist. After neurolysis and tophus resection, a rapid and very substantial relief of paraesthesiae was seen. Recovery of partial active wrist and finger movements required a variety of surgical interventions. The results are analysed after 2 years for the first case, and 8 months for the second.

Deforming chondrosarcoma of the fingers secondary to a long-term enchondromatosis of 28 years.

Enchondromatosis of the hand in the context of the Oilier disease is an infrequent pathologie associated with a high rate of malignancy. In this work, we present a case with multiple enchondromas affecting mainly the fourth and fifth rays of the hand, and with multiple ipsilateral lesions in the foot, sacroiliac joint and iliac bone. This patient is, in addition, an unusual case for a long-term progression (28 years), serious deforming appearance and for the double malignant degeneration to chondrosarcoma of the affected fingers. Clinical features, tumor factors, criterion of diagnosis and prognosis, surgical strategy and follow-up evaluation are analysed, as well as a review of the literature.