This study reports the causes, characteristics and treatment of injuries to the hand and wrist presented to five accident and emergency departments in a 2-year survey of 13% of the Danish population. The rate of injury to the hand or wrist was 28.6% of all injuries, or 3.7 per 100,000 inhabitants per year. 34% of the accidents were domestic, 35% were leisure accidents, 26% were occupational and 5% were traffic accidents. Only 2% of the patients were admitted to hospital for further treatment or observation and 13% were referred to a hospital as outpatients. The most frequent causes for admission were fractures (42%), tendon lesions (29%) and wounds (12%).

Twenty patients with osteochondritis dissecans of the ankle were reviewed for a clinical and radiographical follow-up 9 to 15 years after surgery including multiple drilling of the lesion combined with excision of loose fragments. The short-term results of surgery were satisfactory: 85 degrees of the patients were improved or cured. At follow-up, more than half of the patients had some degree of pain during activity, and swelling of the ankle, but only a few had locking or pain at rest. Only one of the 18 patients without osteoarthritis at the time of surgery had developed generalized osteoarthritis at the follow-up. Although the initial good results of surgery were demonstrated to deteriorate with time, the procedure can still be recommended in patients with longstanding symptoms.

Resection of the posterosuperior aspect of the calcaneus was performed on 43 heels, in 35 patients with chronic retrocalcaneal bursitis. Forty heels in 32 patients were reviewed either by a clinical and radiographical examination (35 heels), or by a questionnaire (5 heels) after an average of 6 years (range 1-12 years). Fifty percent of the heels were cured and additionally 20% improved, but when surgery was performed within 1 year, 92% of the heels were either cured or improved. No correlation was found between the result of surgery and the estimated size of the resection made at surgery.

We conclude that the use of Norian SRS to supplement pin and screw fixation is effective in maintaining the reduction of unstable intra-articular distal radius fractures in osteoporotic patients and provides a better clinical outcome than percutaneous pinning.

A 10 mm wide ring graft from the second extensor compartment with periosteum from the floor of the sheath was used to correct bowstringing in six patients who sustained an isolated rupture of the A2 pulley. It was attached to the lateral rims of the sheath. Periosteum was used for additional graft fixation. Bowstringing was assessed by magnetic resonance imaging and ultrasound preoperatively and 19.5 months after surgery. It was corrected in five patients and improved in one. Pain was reduced from 35 to 7 points on a visual analogue scale. Digital circumference decreased from 76 to 71 mm. Flexion at the PIP joint increased from 88 degrees to 116 degrees. Pinch grip improved from 28 to 56 N.