We found triple nerve block at the knee to be a safe and reliable method of regional anesthesia providing low morbidity, high success rate, long acting analgesia, and fewer complications than general or spinal anesthesia. It is a simple method that can be performed by the orthopaedic surgeon.

Osteoid osteomas of the distal phalanx of fingers are uncommon, which illustrates the difficulties in diagnosis. The authors report a case of a 5 year-old girl who presented a painful swelling of the distal phalanx of her right index finger. The phalanx was enlarged with a nail clubbing. Symptomatology had occurred at the age of 18 months. Unnoticed trauma was advocated. The patient underwent two surgical procedures before the diagnosis was brought up and confirmed by tomodensitometry. The tumour was removed, providing pain relief and improved appearance of tip and nail. One year follow-up shows no tumoural recurrence and a satisfying cosmetic appearance. A review of the literature points out that the diagnosis of osteoid osteoma of the distal phalanx is often delayed for several months or years. A better awareness of this tumour may prevent delay in diagnosis and unnecessary operations.