We describe the case of a 58-year-old woman with AVN of the left trapezium which was treated surgically. This paper aims to review the etiologies leading to the pathology and the different therapeutic options. Avascular necrosis (AVN) of the carpal bones most commonly involves the lunate and the scaphoid . AVN of the trapezium is extremely rare. To our knowledge only 3 cases have been published in the literature so far and they were all treated differently.

Negative pressure wound therapy (NPWT) is a well-known and proven treatment for wound care. However, its use on bone tissue hasn't been described so far. Wounds with visible bone tissue are difficult to manage and the results are often disappointing. We describe the case of a 75-year-old man, with cutaneous necrosis and underlying exposed hardware 7 weeks after a tibial shaft fracture treated by open reduction and internal fixation. After hardware removal, and because of the impossibility to close the soft tissue, a NPWT was directly applied to the bone. The results were encouraging, and a simple skin graft was sufficient after NPWT treatment. Through this case and after a review of the literature, it seems appropriate to extend the indications of NPWT as a salvage solution for exposed bone wound. Further studies are needed to determine the limits of this therapeutic option and to compare it with the already existing treatments.