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Introduction: Tumors in the hand are rare, and malignant tumors in the hand are peculiar; However, primary pseudotumoral lesions of the hand, such as ganglion, are very frequent. Most of the tumors found in the bone and soft tissue can be presented in the same way in the hand but their frequency and distribution is different. Despite the low incidence of benign and malignant tumors in the hand, these can be locally invasive or compromise the hand function. The main objective of this study is to determine the epidemiology, types, location and management of tumors and pseudotumors of the hand in adults in the Mexican population., Material and Methods: We designed a retrospective study by review of clinical records of patients in our institution with diagnosis of tumors or pseudotumors in hand from January 2007 to December 2016 evaluating variables such as age, gender, laterality, Diagnosis, histological lineage, localization and treatment., Results: Our study comprises 215 patients with an average age of 44.23 years, predominantly women. Pseudotumors are the most frequently encountered (synovial cyst), followed by benign soft tissue tumors, benign bone tumors, and, finally, malignant tumors., Discussion: After all we suggests a possible new classification for the hand that is simple, reproducible and give guidance for treatment. The need for a classification system is imminent to standardize diagnostics, guide future research, focus treatments and preserve hand function.

Background: Carpal tunnel syndrome (CTS) is the upper extremity neuropathy more frequent. Treatments led to the entrapment of the median nerve in the carpal tunnel are more complicated and the results less promising and unsatisfactory in diabetic patients. The objective of this study is to compare the results of strength and hand function in healthy patients against patients with diabetes mellitus type 2 (DM2) with a diagnosis of CTS before and after the open and endoscopic release of the carpal tunnel., Material and Methods: This is an observational, retrospective and descriptive study for a period of five years where we evaluated the results in healthy patients and with DM2, with diagnosis of CTS who underwent surgical treatment by open or endoscopic approach; we applied the DASH questionnaire, force grip and clamp fine measurements, presence of infection, pain and complications., Results: The results of 86 patients evaluated, showed a statistical association in the decrease in scores on the functional scale DASH with both approaches, association between remission of hypoesthesias in healthy patients with either of the two approaches as opposed to diabetic patients and association between developing DM2 and complications in the short term., Conclusion: Both approaches improve symptoms and function of the hand in healthy and diabetic patients, but the fi rst group will present cases of complete remission in contrast to the group of diabetic patients.

Introduction: Functional results of four surgical techniques to resolve the IIIB-IV Litchman's stage of the Kienböck disease were analyzed. We observed the evolution from 2000 to 2015., Material and Methods: Transversal retrospective study of 33 patients treated with different surgical techniques and evaluated with Quick-DASH scale, dynamometer and EVA., Results: Less functional limitation was found in the patients who underwent the intercarpal fusion with or without neurotomy of the posterior interosseous., Discussion: It was shown that the fact of making a less aggressive surgery is enough to evolve into an increase in symptoms and a decrease in function and strength; therefore, the intercarpal fusion performed at the right time of the natural history of the disease can achieve better results than other methods used previously and endorsed by international associations., Conclusions: The surgical technique of choice in our series to prevent disease progression was the intercarpal fusion and neurotomy of the posterior interosseous nerve.

Introduction: Fractures of the distal end of the radius are very frequent in the orthopedist's practice. The anatomical reduction of the articular surface and the extra-articular alignment of the radius are extremely important to minimize complications. The purpose of the study is to make an arthroscopic diagnosis of the lesions associated to the distal radius and assist in the reduction of the distal radius fracture., Material and Methods: The study was conducted from March 2007 to February 2008. We performed 20 wrist arthroscopies in 20 patients with an intraarticular fracture of the distal end of the radius. They were classified according to Frykman's criteria. Patient age ranged from 17 to 67, with a mean of 38.7 +/- 15.9 years. 60% were males and 40% females; mean follow-up was 12 months; the chondral lesions were classified according to Outerbridge, the interosseous ligament lesions and the triangular fibrocartilage lesions, according to Palmer's criteria. We did articular debridement, radiofrequency chondroplasty, and assisted the fracture reduction. We used Henry's palmar approach and did open reduction and internal fixation with a T-shaped palmar plate and finally performed an arthroscopy to check the reduction., Results: 8 cases had chondral lesions (grades II to IV); 7 cases had lesion of the triangular fibrocartilage (central isolated ruptures, radial detachment of the triangular fibrocartilage from the sigmoid notch), 5 cases had lesion of the scapholunate ligament; one case had a lesion of the luno-pyramidal ligament, and in 6 cases no associated lesions were found; 8 cases had a single lesion and 6 cases had 2 to 3 concomitant lesions. Two patients had been lost at the 3- and 6-month follow-up visits; 35% of those that were followed-up had pain at 3 months (7 patients) and 15% at 6 months. Only 2 cases had scapholunate instability and only one case had distal radioulnar instability., Conclusions: Arthroscopy has proven useful in identifying hidden lesions, assisting in fracture reduction and even treating the lesions found at the time of the diagnosis. Chondral lesions were the most frequent ones, followed by lesions of the triangular fibrocartilage; a close relation was found between the type of Frykman fracture and the associated lesion. Type 7 and 8 lesions were more frequently associated with chondral lesions and with a higher mean age. At the end of the follow-up period the scapholunate ligament lesions remained unstable. Chondral lesions were related with persistent pain at 3 months.