The hook plate technique for fixation of phalangeal avulsion fractures.

Background: Avulsion fractures of the phalanges involve small osseous fragments that are usually attached to structures that are necessary for stability or movement of the joint. Satisfactory healing of the fracture to preserve joint function may require open reduction and internal fixation, which can be difficult because of the small size of the fragments.

Methods: We used a hook plate fashioned from a 1.

Rice bodies, millet seeds, and melon seeds in tuberculous tenosynovitis of the hand and wrist.

Tuberculosis (TB) is still endemic in many developed countries. Involvement of the hand and wrist at presentation is extremely rare, and the diagnosis is often missed. Operative findings of "rice bodies, millet seeds, or melon seeds" are highly suggestive of tuberculous tenosynovitis.

Hazards of steroid injection: Suppurative extensor tendon rupture.

Local steroid injections are often administered in the office setting for treatment of trigger finger, carpal tunnel syndrome, de Quervain's tenosynovitis, and basal joint arthritis. If attention is paid to sterile technique, infectious complications are rare. We present a case of suppurative extensor tenosynovitis arising after local steroid injection for vague symptoms of dorsal hand and wrist pain.

Resurfacing hemipulp losses of the thumb: the cross finger flap revisited: indications, technical refinements, outcomes, and long-term neurosensory recovery.

Volar-oblique injuries of the thumb pulp are particularly disabling. Many methods have been described to treat these injuries and provide return of sensibility. The conventional cross finger flap is an established technique and is well suited for intermediate-sized partial pulp losses.

Flap resurfacing of postinfection soft-tissue defects of the hand.

Background: Severe suppurative infections of the hand require antibiotics and excisional debridement for control and reversal. This sometimes results in large soft-tissue defects for which primary closure may not be possible.

Methods: Thirty-one patients had postinfection soft-tissue defects of the hand that were resurfaced using flaps.

Diagnostic dilemmas in unusual presentations of gout.

Background: Gout is known to mimic conditions as diverse as joint and soft tissue infections, skin malignancies, nerve compression syndromes and soft tissue tumours. Upper limb involvement is unusual.

Objective: We discuss four cases of gout in the hand and wrist masquerading as a soft tissue tumour, nodular extensor tenosynovitis, septic arthritis of the wrist and acute and chronic median nerve compression.

Pincer nails complicated by distal phalangeal osteomyelitis.

Besides the known cosmetic implications, pincer nails are often complicated by pain, chronic inflammation and recurrent suppurative infections. We report two such cases of chronic paronychia of the thumb secondary to pincer nails. Both were complicated by osteomyelitis.

Factors affecting the prognosis of pyogenic flexor tenosynovitis.

Background: Pyogenic flexor tenosynovitis is a closed space infection involving the digital flexor tendon sheaths of the upper extremity that can cause considerable morbidity. The purpose of the present report is to describe the various risk factors leading to poor outcomes and to recommend a clinical classification system for this condition.

Methods: We studied seventy-five patients with pyogenic flexor tenosynovitis over a six-year period.

Mycobacterium marinum as a cause of chronic granulomatous tenosynovitis in the hand.

Objective: Mycobacterium marinum is an uncommon cause of chronic granulomatous flexor tenosynovitis and leads to significant morbidity in the hand. This paper aims to review our treatment of this infection and its clinical outcomes.

Methods: We treated five cases of M.