Over the last 3 years we have observed 5 cases of median nerve schwannoma that clinically simulated carpal tunnel syndrome (CTS). We describe the atypical clinical-neurophysiological picture indicating to perform ultrasonography (US). We retrospectively re-evaluated 5 cases of schwannoma that clinically simulated CTS. Five consecutive patients were referred to the neurophysiopathology laboratory. All patients complained of symptoms and had a neurophysiological examination that might have indicated CTS. Nevertheless we performed US because of some incongruous aspects. In cases of atypical abnormalities at neurophysiological and clinical examination, or dissociation between neurophysiological and clinical findings, physicians should consider the presence of a median nerve tumour. Here, US evaluation is very useful as supporting diagnostic methodology to assess the anatomopathological condition of the nerve lesion and must not be limited to the wrist.

BackgroundThe purpose of this study was to evaluate the outcome of fractures of the distal radius with metaphyseal and diaphyseal involvement treated with fixed angle volar plates.Materials and methodsTwenty-one patients with fracture of the radius involving the diaphyseal, metaphyseal and epiphyseal parts were treated with fixed angle plate fixation through an extended volar Henry’s approach. Circle wire loops, screws and intrafocal wire fixations were associated in 12 cases. Coexisting ulnar fractures were fixed with plates or K-wires in 8 cases. All patients were prospectively followed using radiographs, physical examination, and DASH (Disabilities of the Arm, Shoulder and Hand) scores.ResultsAll fractures except one, which needed a secondary bone graft to achieve consolidation, united by an average of 90 days. One case developed a radioulnar synostosis. Radiographs showed optimal reduction in 17 of 21 cases, with restoration of radial length in all cases and a neutral average ulnar variance. Nonanatomical reduction was associated with the worst results (P = 0.0006). Flexion and extension averaged 62.8° and 73.8°, and pronation and supination 85.2° and 80.2°, respectively. The average DASH scores were 30 points at 3 months, 14 points at 6 months, and 6.7 points at the time of final follow-up (at an average of 11 months). According to the Mayo wrist rating system, 14 patients showed excellent results, 5 showed good results, and 2 showed fair results.ConclusionFixed angle volar plates were demonstrated to be a safe and efficient treatment in these challenging fractures.

Digital trauma amputations and digital agenesis strongly affect the functionality and aesthetic appearance of the hand. Autologous reconstruction is the gold standard of treatment. Unfortunately, microsurgical options and transplantation procedures are not possible for patients who present contraindications or refuse to undergo transplantation from the toe (e.g. toe‐to‐thumb transplantation). To address these issues, osseointegrated finger prostheses are a promising alternative. The functional assessments registered during follow‐up confirmed the promising outcomes of osseointegrated prostheses in the treatment of hand finger amputees. This review outlines (a) a detailed analysis of osseointegrated finger metallic components of the implants, (b) the surgical procedures suggested in the literature, and (c) the functional assessments and promising outcomes that demonstrate the potential of these medical osseointegrated devices in the treatment of finger amputees.

We describe two cases of bizarre parosteal ostechondromatous proliferation (BPOP), commonly known as Nora's lesion from the author who first described it, arising from the hands of two middle-aged patients. We emphasize the rarity of this lesion and the difficulty in diagnosis, since the histological pattern may mimic that of a malignant sarcoma.

We report a case of extravascular papillary endothelial hyperplasia following surgery for De Quervain’s disease, clinically presenting as an angiosarcoma.