IN 1901 Henri Secretan1 reported the development of a posttraumatic edema of the dorsum of the hand or foot. The salient characteristic of this process is a hard edema of the dorsal metacarpal region and the base of the fingers in which there is marked restriction of digital flexion with the exception of the thumb. Then, as now, the necessity of ascertaining appropriate compensation for insurance claims fell to the lot of the physician. Dr. Secretan, in his capacity as an insurance consultant, was aware of the lack of understanding of this entity in the general medical population and was accordingly prompted to present his series of patients.
It is readily apparent from a sampling of surgical literature2-4 that there is little agreement concerning the classification, the pathophysiology, the prognosis, or even the most effective management of such patients. Our recent experience with one such patient and our