Case: A 32-year-old man presented to the emergency department with several carpal bone fractures and a locked distal pisiform dislocation after trauma. Treatment consisted of open surgical and reduction, osteosynthesis with a single Kirschner wire, and ligament repair. The patient's functional outcome was excellent, and his Mayo wrist score was 90 at 36 months after injury. Conclusions: Pisiform dislocations may be difficult to diagnose because anteroposterior and lateral radiographs may not be sufficient to visualize the injury. A 30° semisupinated wrist x-ray and computed tomography can be helpful. A satisfactory clinical result may be achieved if distal pisiform dislocations are detected early and managed surgically with open reduction and ligament repair.

OBJECTIVE: The aim of this study was to evaluate whether careful physical examination is as effective in diagnosis as magnetic resonance imaging (MRI) in pediatric patients with suspected scaphoid fractures and whether radiography is sufficient in the follow-up of these patients. METHODS: This prospective study included patients with tenderness of the anatomic snuffbox on physical examination and no fracture on radiography between 2015 and 2019, and the data were evaluated retrospectively. A short-arm thumb spica casting was applied for an initial diagnosis of suspected scaphoid fracture. MRI was performed within 1 week after initial trauma. Physical examination and X-rays at 2-week intervals were applied during the follow-up period. The functional outcomes were evaluated using the Modified Mayo Wrist score. RESULTS: A total of 92 patients (28 girls and 64 boys; mean age: 12.32 +/- 2.22 years) were diagnosed with suspected scaphoid fracture on physical examination and MRI was performed. The MRI confirmed the suspected scaphoid fracture at the rate of 77.2% (n=71). The sensitivity obtained for the radiograph was 14.08%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 25.61%. The mean Modified Mayo Wrist score was 92.43 +/- 2.64 (range, 85-98). CONCLUSION: Detection of tenderness on the anatomic snuffbox without determination of fracture radiographically should be evaluated and treated in favor of a scaphoid fracture. These fractures are mostly treated successfully with conservative treatment.

Isolated proximal and distal interphalangeal joint (DIPJ) dislocations are widely seen as a result of sporting injuries and major trauma. The combination of dorsal dislocation of the DIPJ in the same finger concomitant to traumatic dorsal dislocation of the proximal interphalangeal joint (PIPJ) is a rarely seen injury. The case is, here, presented of a 65-year-old female patient with proximal and DIPJ dislocation of the right-hand ring finger accompanied by volar and dorsal plate injuries in the proximal and distal joints.With this case, it was aimed to introduce a new term of "floating phalanx" into medical literature.The treatment was applied to the patient of closed reduction under peripheral block and the application of an aluminium finger splint in semiflexion. In a 24-month follow-up period, the 4th finger of the patient was observed to be stable and has pain-free range of movement. This case is an uncommon case of volar and dorsal plate avulsion fractures with PIPJ and DIPJ dorsal dislocation treated successfully with closed reduction and conservative treatment with excellent functional results.