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In view of the comparative frequency of posterior dislocations of the elbow, it is rather remarkable that anterior dislocations of that joint should be among the rarest of injuries [1]. Our case is one of the first cases of anterior dislocation of the elbow without any periarticular fracture or pre-existing deformities around the elbow [2].

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OBJECTIVES: The aim of this study is to show the benefits of surgical treatment of intra articular fractures of the base of the fifth metacarpal by intermetacarpal double pinning. PATIENTS AND METHODS: It is a retrospective study of 20 cases of intra-articular fractures of the base of the fifth metacarpal treated by percutaneous pinning, between January 2004 and December 2010. All patients had a closed reduction and intermetacarpal double pinning. RESULTS: After a mean of 19 months, we could review only 18 patients. The overall results were satisfactory, except for two patients who reported intermittent pain with changing weather and intense use of the hand, and a case of reflex sympathetic dystrophy syndrome after surgery. The evaluation of results was based on clinical criteria related to pain, mobility and grip strength, and on radiological criteria after analysis of specific hemato-metacarpal radiographs. CONCLUSION: Intermetacarpal double pinning is a technique of choice in surgical treatment of intra-articular fractures of the base of the fifth metacarpal. It ensures good closed reduction and a satisfactory functional result.

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OBJECTIVES: The interest of this work is to show the benefits of surgical treatment of Bennett fractures by intermetacarpal double pinning. PATIENTS AND METHODS: It is a retrospective study of 24 cases of Bennett fracture treated by intermetacarpal double pinning, between January 2005 and December 2009. The treatment was surgical for all patients. The intermetacarpal double pinning using the technique of Iselin has been reserved for fractures with small fragment found in the series in 18 cases (72% of operated patients), and by Tubiana in six cases (24%). RESULTS: After a mean of 36 months, we could follow only 21 patients, the evaluation of results was based on clinical criteria relevant to pain, mobility and the pinch grip, and on criteria after radiological analysis of radiographs specific trapezo-metacarpal. All fractures were consolidated. Two cases of moderate osteoarthritis were observed. Overall, the results were excellent in 15 patients (71%), good in four patients (19%) and poor in two patients (10%). CONCLUSION: Intermetacarpal double pinning is a technique of choice in surgical treatment of Bennett fracture. It ensures a good closed reduction and a satisfactory functional result.

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Primary vascular tumours of bone are rare. Haemangiomas occur as incidental findings in the skull or in the spine. A solitary haemangioma of the hand skeleton is rare and difficult in radiological and histological differential diagnosis. We report a case of a 23 year-old patient presenting with a capillary hemangioma of the left second finger of few months duration for which he underwent amputation. Postoperative evolution was good and showed no recurrence. We discuss this through observation and a review of the literature including the different clinical, radiological and pathological diagnostic problems associated with an unusual site for vascular proliferation.

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Bone metastases in the hand are rare. The authors report a case of a 46-year-old woman diagnosed with a giant hand tumor, revealing a lung adenocarcinoma. An amputation of the thumb was performed. Histology confirmed a metastasis from the lung adenocarcinoma.

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Tumors of the biliary tract are rare, and their survival prognosis is short since diagnosis is often made at advanced stages of the disease. Diagnosis remains difficult because symptoms are often unspecific. Bone metastasis from biliary carcinoma are rare. We report a case of a humeral metastasis revealing a biliary carcinoma.

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The authors report in the treatment of fractures of the proximal phalanx of the fingers, the use of Eiffel Tower pinning, a relatively simple method, fast and stable, associated to a protection and early rehabilitation. The objective of this method is to offer to the patient a pollici-digital grip. Our study is a retrospective study of 45 patients treated for fractures of the proximal phalanx of the fingers by percutaneous pinning according to Eiffel Tower method. We detail this simple and economic technique and examine the functional and radiological results of this series of patients. The amplitude of the active total motion of the proximal interphalangeal joint is on average 94.16 degrees (78.5 % of the normal active mobility of the proximal interphalangeal joint), and the amplitude of the active total motion of the metacarpo-phalangeal joint is on average 90.05 degrees (75 % of the normal active mobility of the metacarpo-phalangeal joint).

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Volar perilunar dislocations of the carpus are rare. They occur in young patients following a violent injury. Open reduction is often needed because of instability of the lesion. The authors report a case of volar transscaphoid perilunate fracture-dislocation treated surgically, with a satisfactory functional result after a follow-up of two and a half years.

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The authors report an unusual case of multiple carpometacarpal joint dislocations of the ulnar four fingers, treated by closed reduction and fixation with percutaneous Kirschner-wires. A plaster splint with the wrist in neutral position was applied for six weeks. Active physiotherapy of the fingers was started from four weeks after surgery, with a satisfactory result.

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Echinococcosis is a widespread zoonosis which is endemic in most sheep-raising countries. Primary isolated muscular localisation is uncommon even in these endemic areas. The authors report a rare case of primary hydatid cyst localized in the myotendinous junction of the flexor digitorum profundus. According to our review of the medical literature, there are no reports of a similar case, making ours the first such report.

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The authors report a series of six cases of acute traumatic dislocation of the trapeziometacarpal joint of the thumb. Displacement was always dorso-radial. There were associated osseous lesions in one patient: avulsion of the palmar tubercle of the base of the first metacarpal with a fracture of the trapezoid. All the patients were treated immediately by percutaneous pinning according to the technique of Wiggins. The late results, evaluated at an average of 19 months postinjury (range: 8-29 months), were considered to be satisfactory in the majority of the patients. Treatment by percutaneous pinning remains a less sophisticated alternative that in our experience yields consistently good results, provided there is no preexisting degenerative articular lesion.

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We report a case of a 30-year-old man with a carpometacarpal joint dislocation of the thumb associated with trapezium and Bennett's fractures. This combined injury pattern appears to be very rare. Since, to our knowledge a similar case was not found in the literature. The lesion was managed with closed reduction and percutaneous pinning, resulting in good functional outcome.