BACKGROUND: metacarpophalangeal dislocations of the thumb are not very frequent injuries, it is necessary to know the anatomy of the region to know possible causes of interposition that prevent a closed reduction of this pathology.
METHODS: we present the case of a 75-year-old woman with a post-traumatic metacarpophalangeal dislocation of the thumb that required open reduction and surgical repair. In this procedure, we performed reduction of the dislocation, mobilization of the interposed structures, repair of the capsule and reinsertion of the ulnar collateral ligament. The early mobilization protocol helped to obtain very good results.
CONCLUSIONS: it is imperative to consider possible associated injuries during the acute phase to achieve optimal short, medium, and long-term outcomes for our patients. A comprehensive and proactive approach to diagnosis and treatment is vital in effectively addressing this pathology and minimizing its potential sequelae.
UNASSIGNED: las luxaciones metacarpofalángicas del pulgar no son lesiones muy frecuentes, es necesario conocer la anatomía de la región para conocer posibles causas de interposición que impidan una reducción cerrada de esta patología.
UNASSIGNED: presentamos el caso de una mujer de 75 años con luxación metacarpofalángica postraumática del pulgar que requirió reducción abierta y reparación quirúrgica. En este procedimiento realizamos reducción de la luxación, movilización de las estructuras interpuestas, reparación de la cápsula y reinserción del ligamento colateral cubital. El protocolo de movilización temprana ayudó a obtener muy buenos resultados.
UNASSIGNED: es imperativo considerar posibles lesiones asociadas durante la fase aguda para lograr resultados óptimos a corto, mediano y largo plazo para nuestros pacientes. Un enfoque integral y proactivo del diagnóstico y tratamiento es vital para abordar eficazmente esta patología y minimizar sus posibles secuelas.

BACKGROUND: Evaluating isolated extremity discomfort can be challenging when initial imaging and exams provide limited information. Though subtle patient history hints often underlie occult pathologies, benign symptoms are frequently miscategorized as idiopathic.
METHODS: We present a case of retained glass obscuring as acute calcific periarthritis on imaging. A 48-year-old White male with vague fifth metacarpophalangeal joint pain had unrevealing exams, but radiographs showed periarticular calcification concerning inflammation. Surgical exploration unexpectedly revealed an encapsulated glass fragment eroding bone. Further history uncovered a forgotten glass laceration decade prior. The foreign body was removed, resolving symptoms.
CONCLUSIONS: This case reveals two imperative diagnostic principles for nonspecific extremity pain: (1) advanced imaging lacks specificity to differentiate inflammatory arthropathies from alternate intra-articular processes such as foreign bodies, and (2) obscure patient history questions unearth causal subtleties that direct accurate diagnosis. Though initial scans suggested acute calcific periarthritis, exhaustive revisiting of the patient\'s subtle decade-old glass cut proved pivotal in illuminating the underlying driver of symptoms.
CONCLUSIONS: Our findings underscore the critical limitations of imaging and the vital role that meticulous history-taking plays in clarifying ambiguous chronic limb presentations. They spotlight the imperative of probing even distant trauma when symptoms seem disconnected from causative events. This case reinforces the comprehensive evaluation of all subtle patient clues as key in illuminating elusive extremity pain etiologies.

BACKGROUND: The conventional treatment of giant cell tumors is intralesional curettage with local adjuvant therapy. Because hand tumors have a high local recurrence, the primary goal for treating tumors of the hand is to eradicate the lesion.
METHODS: To preserve the metacarpophalangeal (MCP) joint function as well as avoid further recurrence after surgery.
METHODS: The giant cell tumor invades the patient\'s MCP joint in an index proximal phalanx.
METHODS: Using computer-aided design and three-dimensional printing techniques, we reformed the original shapes of the MCP joint and its peripheral bone to replica models. The surgeon then performed an en bloc resection and proximal phalanx with MCP joint reconstruction by fabricating the patient\'s costal osteochondral graft during the operation.
RESULTS: After 6 months of rehabilitation, the patient\'s finger functions could pinch and grasp objects naturally. At the 1-year follow-up, the range of motion of the MCP, proximal interphalangeal, and distal interphalangeal joints improved from flexion of 35° to 60°, 75° to 85°, and 60° to 80°, respectively. The hand function achieved the mean performance of non-preferred hands for young females at the postoperative 3-year follow-up.
CONCLUSIONS: The customized prototyping technique has the potential to replica the original patient\'s bony graft to reach the goal of minimizing the defects at the donor site and maximizing the function of the reconstructed MCP joint.

METHODS: A 54-year-old male with osteoarthritis of the right long finger metacarpophalangeal joint underwent PyroCarbon joint arthroplasty. Seven years later the patient presented for metacarpophalangeal joint swelling and pain. The workup was benign, without signs of implant complication or osseous abnormality. He underwent washout and two-stage revision, where gross implant wear and debris not demonstrated by radiograph were found. He then returned to the operating room for reimplantation of a PyroCarbon implant.
CONCLUSIONS: This case demonstrates a novel presentation of aseptic PyroCarbon implant failure in the hand without radiographic abnormality that can alter operative management by reducing operating room returns.

UNASSIGNED: Extensor tendon subluxation or dislocation resulting from sagittal band rupture can be associated with snapping, catching, locking, pain, and swelling of the finger. Several etiologies were reported in the literature, with frequent mention of a traumatic rupture caused by a direct blow at the level of the metacarpophalangeal joint (MCPJ). The other causes of sagittal band injuries are degenerative disease, congenital infection, and rheumatoid arthritis. To our knowledge, we report the first case of spontaneous idiopathic bilateral sagittal band rupture.
UNASSIGNED: We, herein, present the case of a seronegative 29-year-old female who presented with pain and swelling in the dominant hand for 4 days.
UNASSIGNED: Upon examination, she was found to have bilateral dislocation of the extensor tendons at the level of the (MCPJ) of the third and fourth digits. Any underlying cause was excluded, and the diagnosis was confirmed with a dynamic ultrasound study.

Snapping of fingers can be caused by pathologies such as stenosing flexor tenosynovitis. However, snapping symptoms in the metacarpophalangeal (MP) joint caused by hypertension and hyperplasia of the lateral band are rare. We present a 26-year-old female with symptoms of painful snapping of the middle finger. When the finger was actively flexed from the hyperextension of the MP joint, the ulnar lateral band was prominent, and a snapping phenomenon occurred. The cause of the snapping finger was considered to be tightness of the ulnar lateral band, and surgery was planned. Intraoperatively, the ulnar lateral band was tense and hyperplastic. The snapping phenomenon disappeared immediately after the resection of the lateral band. It is important to consider this condition as one of the differential diagnoses of snapping finger when the patient complains of an atypical snapping phenomenon.

OBJECTIVE: Pilonidal sinus of the hand is an occupational hazard for barbers, cow milkers, sheep shearers and dog groomers. Here, we report on a dog groomer who had four pilonidal sinuses.
METHODS: A 49-year-old woman working as a dog groomer complained of multiple non-erythematous and fluctuant nodules on both hands, associated with pain, which had been identified five years previously. On the skin of her right hand, three nodules were observed on the volar (diameter: 1.5 cm) and medial (diameter: 1.4 cm) sides of fifth metacarpophalangeal joint and the volar aspect of the distal phalanx of the small finger (diameter: 0.7 cm). On the left hand, a 2-cm diameter nodule was identified on the volar side of the fifth metacarpophalangeal joint region. The nodules were excised surgically. A 5-mm long hair was removed from one nodule. Histopathology confirmed pilonidal sinus, treated by excision. One month postoperatively, the wound had healed uneventfully.
CONCLUSIONS: When nodules are found in dog groomers, clinicians should consider the possibility of pilonidal sinus disease.

UNASSIGNED: Traumatic bone loss at the metacarpal phalangeal joint level can be a challenging clinical situation. Not many cases have been described in the literature for this specific articulation.
UNASSIGNED: Our patient presented with a work-related accident of his hand with loss of the metacarpophalangeal joint of the index finger. After temporary external fixation and wound closure, a prosthetic joint arthroplasty was chosen to allow a reconstruction of his lost joint.
UNASSIGNED: After traumatic articular bone destruction in the hand, there are several possibilities to reflect on. Taking into consideration the patient\'s characteristics and the degree of bone loss, implanting a prosthesis can be a safe option with acceptable results.

UNASSIGNED: We present a rare case of ischemia caused by blunt trauma at the metacarpophalangeal joint, with no fracture or dislocation. This case resulted in digital arterial injury of the little finger with a pathological mechanism similar to that of hypothenar hammer syndrome (HHS).
UNASSIGNED: Pre-operative computed tomography (CT) revealed an occluded ulnar artery at the brachial artery bifurcation and occluded ulnar digital artery in the little finger. The blunt trauma to the radial digital artery of the little finger caused ischemia. Arterial anastomosis was performed microsurgically to preserve the little finger. Necrosis was successfully prevented. The condition of the finger improved gradually, with no restriction in the range of motion.
UNASSIGNED: When a patient presents with HHS-like symptoms and is unresponsive to conservative treatment, surgical treatment should be considered. We recommend using contrast-enhanced CT for evaluating the entire upper extremity, even for ischemia associated with blunt hand trauma, such as HHS.

A 27-year-old man underwent metacarpophalangeal joint reconstruction of his right middle finger using vascularized tissue from the distal component of the metatarsophalangeal joint of the right second toe. The donor site was reconstructed using a portion of the iliac bone and overlying tendinous fiber. The reconstructed metacarpophalangeal joint was stable 2 years postoperatively, and the arc of active motion was 80°. The reconstructed metatarsophalangeal joint did not interfere with walking. Radiography revealed the satisfactory condition of these joints.
Depending on the type of defective joint and soft tissue injuries, vascularized partial joint transplantation could be considered for reconstruction.