[Management of painful pseudarthrosis of the carpal scaphoid bone with closed wedge osteotomy of the distal radius: a prospective study with long-term follow-up].

Purpose Of The Study: We propose a different management scheme for painful post-traumatic osteoarthritis of the wrist resulting from pseudarthrosis of the carpal scaphoid bone. We report a prospective series with a maximum follow-up of 16 years.

Material And Methods: From 1973 to 1990, we performed 100 first-intention wedge osteotomies of the distal radius in patients with painful pseudarthrosis of the carpal scaphoid bone.

Wedge osteotomy of the lower end of the radius in the treatment of painful pseudarthrosis of the carpal scaphoid bone.

The present authors have had encouraging results in the treatment of painful pseudarthrosis of the carpal scaphoid bone using wedge osteotomy on the lower end of the radius. After the operation, patients experienced restoration of joint movement, less painful or pain-free joints, and, in a few cases, sound union of the established pseudarthrosis of the carpal scaphoid bone. Osteotomy is a simple procedure of short duration and is without complications.

Variations of palmaris longus.

Although variations of palmaris longus muscle are described in anatomical text books, they are seen rather rarely in practice. Within the last five years of hand surgery we came across threee different cases of such variations described in the above text. We believe that every surgeon must be aware of them, since this, otherwise unimportant muscle, provides a very useful graft in tendon surgery.

Osteoid osteoma of the terminal phalanges.

Four cases of osteoid osteoma of the terminal phalanx--a very rare location--are presented. The clinical picture of cell cases is essentially the same, gradual swelling of the terminal phalanx with enlargement of the nail and pain, particularly at night and relievable by aspirin. The treatment was operative and of double value.

Dorsal dislocation of the first metatarso-phalangeal joint. Report of four cases.

The anatomy of the first metatarso-phalangeal joint and of dorsal dislocation of the phalanx are described. As similar lesions in the hand, closed reduction is impossible because of interposition of the volar plate. Open reduction is essential and should be performed as soon as possible after the injury.