Osteonecrosis of the trapezium: a case report and review of the literature.

We describe the case of a 58-year-old woman with AVN of the left trapezium which was treated surgically. This paper aims to review the etiologies leading to the pathology and the different therapeutic options. Avascular necrosis (AVN) of the carpal bones most commonly involves the lunate and the scaphoid . AVN of the trapezium is extremely rare. To our knowledge only 3 cases have been published in the literature so far and they were all treated differently.

Metacarpal chondrosarcoma, from negligence to rareness : a case report and review of the literature.

Chondrosarcoma is rarely found in the extremities but it remains the most common primary malignant bone tumor of the hand. We report an unusual case of a 46-year-old man with a huge chondrosarcoma on his left hand that has been evolving for more than 30 years. The mass has always been painless, the symptoms were only the deformation and a slight loss of motion. We did a subtotal resection since the patient refused the amputation. The investigation, which in- cluded thoracoabdominal tomography, scintigraphy and blood analysis, turned out to be negative. In the literature, CS are usually associated with a locally destructive growth but metastasis hasn't been often described. CS seems to be an aggressive tumor locally but, unlike in other sites, it seems to rarely metastasize when in the hands.

Resection of the flexor digitorum superficialis for trigger finger with proximal interphalangeal joint positional contracture.

PURPOSE: Open release of the A1 pulley is a widely known procedure for the treatment of trigger finger. A subset of patients presents with both trigger finger and a positional contracture of the proximal interphalangeal (PIP) joint. These patients usually have a long history of trigger finger or have already undergone a surgical release of the annular pulley. This study is a retrospective review of the outcomes of resection of the flexor digitorum superficialis (FDS) for patients whose trigger finger was associated with a positional contracture of the PIP joint. METHODS: Thirty-six patients (39 fingers) were treated by resection of the FDS after section of the A1 pulley. The mean age of the patients was 63 years (range, 45-90 y). Seven patients (19 %) had previously undergone an open release of the A1 pulley and had developed a positional contracture of the PIP joint 2 to 5 months afterward. We performed a retrospective review with a mean follow-up of 30 months (range, 12-60 mo). No patient was lost to follow-up. The active range of motion was recorded at the PIP joint before and after surgery. RESULTS: The mean preoperative positional contracture of the PIP joint was 24° (range, 15°-30°). The mean postoperative positional contracture of the PIP joint was 4° (range, 0°-10°). The most commonly affected digit was the middle finger (26 fingers, 67%). In 28 fingers (72%), full extension was achieved following only the surgical procedure. The remaining 11 fingers (28%) had a postoperative residual positional contracture (range, 5°-10°). However, all fingers achieved a full range of motion after physical therapy and an injection of betamethasone. All of the resected tendons had histological damage. CONCLUSIONS: This technique is a useful treatment for selected patients whose trigger finger is associated with a positional contracture.