The Dog Bite, the Acrometastasis and the Disappearing Hamate.

In this case report, we describe a peculiar case of basaloid squamous cell carcinoma of the lung that was first diagnosed from a hamate metastasis. Acrometastases are bony metastases that are located distal to the elbow and knee. They generally become symptomatic only when a primary tumour has been identified. However, in this instance, the patient first sought medical attention following a dog bite to the ulnar side of the wrist, and thus the acrometastasis was diagnosed first, which is uncommon. We discuss the learning points relating to the unusual presentation of this case, classical acrometastatic features and a review of the literature.

Management of acute scaphoid fractures: a pragmatic approach for the non-specialist.

Scaphoid fractures are common and can cause significant morbidity if treated incorrectly. Thus, a working knowledge of the initial assessment and management of scaphoid fractures by non-specialists is crucial to allow quick diagnosis and avoid potentially catastrophic complications of scaphoid fracture. This article summarises the anatomy of the scaphoid, discusses methods to assess for scaphoid fractures and delineates management plans (conservative or operative) for fractures of the scaphoid based on location of vascular compromise. This article can also help the clinician predict which fractures may not unite with conservative management and therefore need referral to a specialist orthopaedic surgeon for possible surgery.