In the United Kingdom, guidelines issued by the National Institute for Health and Clinical Research (NICE) suggest the routine use of MRI when a scaphoid fracture is suspected based on interview, examination findings, and normal scaphoid-specific radiographs [5]. This clinical scenario is often referred to as a “suspected scaphoid fracture” [16]. An alternative strategy for managing suspected scaphoid fractures is based on the management of other fractures that predictably heal (such as metacarpal fractures and isolated nondisplaced or minimally displaced radial head fractures) and is premised on the idea that if a fracture is likely to heal without serious sequelae, then overtreatment represents a risk as great as undertreatment. The alternative pathway for the care of patients who present to emergency departments with a history, signs, and symptoms potentially consistent with scaphoid fracture involves providing patients with information about the expected course of recovery and specific instructions about how to seek more care if desired.

El gold standard del tratamiento del síndrome del túnel carpiano (STC) es la sección del ligamento transverso del carpo, siendo la técnica más común la incisión cutánea palmar. Se han desarrollados técnicas percutáneas, aunque su relación riesgo/beneficio sigue siendo controvertida.

Palmar (volar) plate interposition arthroplasty for osteoarthritis (OA) of the metacarpophalangeal (MCP) joints of the fingers is a well-established technique. Its use has diminished since its initial description and introduction because of poor results in patients with inflammatory arthropathy and a difficult surgical technique. We report the surgical technique and mid-term results of the novel Nottingham interposition arthroplasty for noninflammatory MCP joint OA. A dual dorsal and palmar incision is utilized to maximize the harvest of interposition substance.

Fingertip injuries are frequently encountered by the hand surgeon, and often present with a combination of the following: avulsed or broken nail plate, nail bed disruption, and/or distal phalangeal fracture. Recommended management of these injuries consists of reduction of the fracture followed by repair of soft tissues.

La fractura de cuello del quinto metacarpiano se trata tradicionalmente mediante la reducción cerrada e inmovilización con férula en intrínseco plus. Una alternativa es el tratamiento funcional mediante sindactilia. Nuestro objetivo es comparar ambos tratamientos buscando diferencias de resultado funcional entre ambas opciones.