Trapezium fractures are very rare and can lead to significant deficit of hand function if missed. The purpose of this article is to document and discuss the surgical treatment performed to a 34-year-old man who sustained a closed isolated vertical split fracture of the trapezium on his left non-dominant hand. The patient was treated at our Orthopaedic Surgery Department. We performed an open reduction (by a dorsal approach) and internal fixation with a headless compression screw. At the last follow-up 6 months post-op, the functional outcome was excellent. The patient had no complains, complete wrist and thumb range of motion and hand grip and pinch strength comparable to the contralateral limb. The Disabilities of the Arm, Shoulder and Hand (DASH) score was 7.5. The technique applied ensured a stable and anatomic restoration of the articular joint surface. We decided to discard post-surgical plaster immobilization, which enabled earlier rehabilitation. Furthermore, we believe that the re-establishment of the articular surface will minimize the long-term degenerative changes at the trapeziometacarpal (TMC) joint.

Bone metastasis with specific involvement of the bones of the hand constitute an event rarely described in the literature. The aetiology is almost exclusive to primary tumours of the lung, with an incidence of 1/500 of all pulmonary lesions that spread to the bone. The diagnosis is extremely challenging, either through the subtle clinic or the mimicry of other entities. The approach to this type of injury is imminently palliative, with the objectives of pain relief and preservation of function. The authors present the case of a patient diagnosed with a proximal phalanx metastases of the thumb as a manifestation of an advanced stage adenocarcinoma of the lung.