A 32 year-old Malay lady presented with a swelling over the dorsal surface of her right thumb for 6 months. The swelling was non-tender, smooth surfaced, mobile and nonfluctuating with no bony involvement. The provisional diagnosis was ganglion cyst. Excisional biopsy did not show features of ganglion cyst as it appeared to be wellencapsulated, multi-lobulated and yellowish in colour. Histopathological examination showed that it was a schwannoma. Schwannomas are relatively rare benign tumours which are frequently misdiagnosed. In this case, it was misdiagnosed both as a ganglion and a lipoma.
A young patient presented to our centre with swollen right hand following a motor vehicle accident. He was diagnosed with closed fractures of trapezoid, ulnar three metacarpal bones, radial styloid and ulnar styloid. The hand injuries were complicated with compartment syndrome. Emergent fasciotomy and application of external fixator of the hand were performed. Definitive fixation of the fractures was delayed due to the wound care post fasciotomy. During the definitive fixation of the hand, the trapezoid was found to be comminuted and completely extruded. Abundant callus was found at the fracture sites of the metacarpal bones. Anatomic fixation was not feasible. Principle-based intra-operative creativity and flexibility were of great significance in the unconventional fixation of the complex hand injuries described in this case report.