Twenty-one patients (17 women and four men) who underwent operative treatment for a solitary enchondroma of the hand were examined at a follow-up of between 2 and 18 years (mean, 9 years). Radiographs showed normal cancellous bone at the site of surgery in 11 cases, three had recurrent enchondroma and seven had bone defects so that recurrence could not be excluded. Two of the three recurrences underwent reoperation. Previous studies have regarded persistent bony defects as evidence of complete excision without recurrence. However, in view of the slow asymptomatic growth of this tumour this opinion is incorrect. As shown in this study, recurrences may occur in these defects many years after excision surgery and go undetected until they cause widening or cortical erosion. We recommend periodical radiological re-examination for asymptomatic recurrences before weakness of bone leads to pathological fracture.

We performed a retrospective clinical and radiological case control study on 22 rheumatoid wrists following radiolunate fusion via Shapiro staples with a mean follow-up of 5 years. Radiographs showed one early loosening through dorsal staple migration and four nonunions. Six wrists fused in mild ulnopalmar dislocation of the lunate. Primary intra-articular positioning of a staple was found in nine wrists, secondary intra-articular staple dislocation was found in two wrists. Dorsal staple dislocation was found in four fused arthrodeses. Osteolysis around the staples was found in all but two wrists. In contrast to unsatisfactory radiological results the clinical results were good or excellent in 18 patients. Good and excellent clinical results in the majority of the patients following radiolunate fusion does not depend on the fixation device. Nevertheless staple fixation of the radiolunate joint in the rheumatoid wrist is associated with a high rate of radiological complications.

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The radiological, clinical and hisiological findings in long-persisting bursitis are often simular to those found in patients with rheumatic disease. Normal laboratory findings do not preclude an early stadium of rheumatic disease. For this reason, these patients had to be instructed to return if they develop further synovialitis to verify the diagnosis and to avoid delayed therapy.