This case is a rare adult type Tillaux fracture. This fracture should be diagnosed in the emergency department. The fracture requires careful evaluation with awareness of associated injury. Standard radiological views (antero-posterior and lateral) of the ankle may not clearly show the fracture displacement hence, an oblique view is required. The fracture should be managed by the emergency physician, if the displacement is less than 2 mm, by immobilising with a non-weight bearing cast or ankle braces for 6 weeks. If the fracture fragment is displaced more than 2 mm, it should be treated by closed reduction failing which open reduction and internal fixation is the standard practice.

Pilonidal sinus is a chronic inflammatory condition owing to the subcutaneous trapping of hair. Most commonly it is found in the sacrococcygeal region (natal cleft) but rarely it is found on the penis with very few cases reported in the literature worldwide. We are reporting a case of a pilonidal sinus growing on the distal penile shaft with the sinus opening to the mucosal layer of the foreskin, in a young and fit patient. The cyst was removed with a circumcision and found to contain hair. This was confirmed by histology as a pilonidal sinus cyst.

Rotatory subluxation of proximal interphalangeal joint of the finger is a rare dislocation that can commonly be missed in a busy Emergency Department resulting in delayed treatment and bony ankylosis. We describe the radiological findings that will help in the diagnosis of this type of complex dislocation and its management. This case highlights the implications of this uncommon injury. Interposition of soft tissues makes this injury difficult to reduce by closed manipulation and open reduction may be indicated. If the condition is undiagnosed, the joint is likely to progress to soft tissue fibrosis and eventual bony ankylosis.