Treatment of dorsal fracture-dislocations of the proximal interphalangeal joint using the shotgun approach

This study assessed the outcome of open reduction and internal fixation of proximal interphalangeal joint fracture-dislocations through a shotgun approach, while keeping hemi-hamate arthroplasty as a back-up plan. After using the shotgun approach, fixation was carried out when the anterior fragment was large enough to accept two 1.5 mm screws. Sixty-three fracture-dislocations were treated in 61 patients, of whom 30 underwent internal fixation. Twenty-one of these were assessed in the final study. At a mean follow-up of 29 months, the mean range of joint motion was 80° and 102° for the injured and contralateral hand, respectively. The mean pinch and grip strengths of injured hand were 82 and 83 of contralateral hand, respectively. The mean disabilities of the arm, shoulder and hand score was 5.5. The mean visual analogue pain score was 1.6. Surgery through the versatile shotgun approach allows excellent intra-operative assessment and acceptable outcomes. Level of evidence: IV. © 2018, © The Author(s) 2018

Intraneural cavernous haemangioma of ulnar nerve and cubital tunnel syndrome

Cubital tunnel syndrome due to cavernous haemangioma of ulnar nerve is a rare condition. In the present study, we report a case of intraneural haemangioma of the ulnar nerve at the elbow in an Iranian woman. A 40-year-old woman with a left elbow pain, ulnar nerve thickness, intrinsic muscle atrophy of the hand and local tenderness was admitted in our hospital. Ultrasound of elbow soft tissue showed a hypoechoic tubular mass (15 � 10 mm) that seen along the ulnar nerve. With the aid of a microscope, removal of tumour with minimal damage to the nerve fascicles was accomplished. Histopathological examination revealed a benign cavernous hemangioma. Nerve compression by an intraneural haemangioma is rare and should be resected with minimal damage to the nerve fascicles. In our cases, dissection was occurred with minimal damage to the nerve fascicles. Postoperative recovery was unremarkable, and the ulnar nerve function remained normal. © 2015, Springer-Verlag London