Simultaneous dislocation of both joints of the thumb with a fracture involving the interphalangeal joint. A case report and a review of the literature.

Combined dislocation of the metacarpophalangeal and interphalangeal joints of the thumb is uncommon, only five cases having been previously reported. In this case report, a previously unreported case characterized by volar-ulnar dislocation of the metacarpophalangeal joint and dorsal dislocation of the interphalangeal joint, associated with a unicondilar open fracture of the proximal phalanx, is presented. Only open reduction for the interphalangeal joint was needed and both (metacarpophalangeal and interphalangeal) joints were treated with K-wire fixation after reduction. Internal fixation of the phalangeal fracture was not performed because of the size of the bone fragment. Although the diagnosis of dislocation of the interphalangeal joint is obvious, a simultaneous dislocation of the metacarpophalangeal joint can be easily overlooked, which is a fact that underlines the importance of this article. It is therefore recommended to examine the whole hand.

Treatment of radial head fractures using a fibrin adhesive seal. A review of 15 cases.

Since 1986 we have treated 15 patients with fractures of the head of the radius limited to one or two fragments (Mason type II) by open reduction and internal fixation with the Fibrin Adhesive System. At a mean follow-up of over two years, all but one of the results were excellent. This method is recommended for the treatment of selected fractures of the radial head followed by early mobilisation.

Idiopathic necrosis of the capitate.

Avascular necrosis of the capitate bone in a 38-year-old man is presented. The patient was treated by intercarpal fusion of the capitate, lunate and scaphoid bone to relieve pain.