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(a,b) Standard X ray of the hand: the black arrow shows the focus of osteomyelitis corresponding to the path of the distal Kirschner wire previously used to treat the Bennett fracture.
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Standard hand X-ray demonstrated the presence of an area of osteolysis surrounded by osteocondensation at the second metacarpal, indicating a focus of osteomyelitis along the path of the distal pin (Figure 1).
(a,b) MRI of the hand shows an intraosseous second metacarpal geode and the path of the fistula indicated by the black arrow.
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It confirmed the diagnosis, revealing the extent of the focus of osteomyelitis, the path of the fistula, and the inflammatory extension into neighboring soft tissues (Figure 2).
First stage post-operative X- ray control after segmental resection, cement spacer interposition and stabilization with mini external fixator.
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X ray control three months after the second stage, showing consolidation of the bone graft.
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Bone healing was observed three months later (Figure 4) with complete disappearance of pain.
Shows full recovery of hand function.
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The patient has regained normal use of the hand with a Quick DASH score of 11 and complete mobility (Figure 5).
(a,b) X- ray at 36-month follow-up shows complete incorporation of the graft with bone corticalization.
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X-ray of the hand shows incorporation of the graft and evidence of corticalization (Figure 6).