Introduction: Chronic osteomyelitis is the bane of orthopedics. Along with being difficult to treat for surgeons, it also impacts the patient’s life immensely, severely restricting their life in all the aspects. Treatment with antibiotic coated cement spacers, which are removed after a duration of 6–8 weeks for the definitive surgery, is a frequently done procedure in conjunction with an adequate debridement of the necrotic tissues and prolonged IV antibiotics. We report a case of acute osteomyelitis superimposed on the chronic osteomyelitis of the left proximal humerus. Case Presentation: An immunocompetent and otherwise healthy 14-year old Indian male who was operated 1 year ago for chronic osteomyelitis presented to us with an acute tense swelling, unbearable pain, and toxemia, with a cement spacer and multiple cement beads in situ. With regards to his initial injury, he had history of fall from height with a puncture wound, possible humerus fracture, treatment by local healers as well as surgical procedures in an outside facility with debridement and placement of cements spacer and beads. On presentation to our facility, removal of retained cement plus debridement was carried out, and after serial surgeries, the defect was successfully treated with the use of antibiotic loaded absorbable calcium sulfate. Conclusion: A basic knowledge about the ideal practices for taking treatment is still inadequate in many population groups within India . It is important to spread awareness of proper healthcare seeking practices among people so that the disability associated time and loss of activity related to injury is significantly reduced. Furthermore, calcium sulfate can be an effective option for treatment of bone defects associated with chronic osteomyelitis.

Introduction:A benign cystic lesion, the simple bone cyst (unicameral/essential bone cyst), it may be found in any long bone (most commonly found in femur and proximal humerus), usually in immature skeletal persons. Metacarpal simple bone cyst is an exceedingly rare occurrence and few treatment options have been described for the same. Case Report: A 42-year-old manual laborer male (right hand dominant) came with history of trivial trauma to right hand thumb with hammer. He complained of mild swelling and pain since trauma. On imaging the right hand, an expansive lytic lesion was seen in the metaphyseo-diahyseal region of the first metacarpal. There was thinning of the cortex with break in cortex visible at mid diaphyseal region. There was absence of any soft-tissue involvement or periosteal reaction. Magnetic resonance imaging reported a T2 hyperintense and T1 isointense benign osteolytic lesion with pathological fracture. On aspiration, a reddish tinged fluid was found. A closed fixation was performed with the help of an intramedullary k-wire. Conclusion:Simple bone cyst, although rare in metacarpal bone, is an important differential diagnosis in cases with cystic lesion. Simple bone cyst, although a benign lesion, can cause extensive involvement of the metacarpal bones and destroy the entire diaphysis. It requires adequate treatment which is simple and effective. Keywords:Simple bone cyst, K-wire, metacarpal.