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Tubercular tenosynovitis of the wrist with carpal tunnel syndrome (CTS) is a rare occurrence. The authors present a case of tubercular flexor tenosynovitis of the wrist with CTS. A 60-year-old female presented with complaints of swelling in the volar aspect of the right wrist with numbness of the first three fingers for the past 6 months. Clinical and radiological diagnosis of chronic flexor tenosynovitis with median nerve compression neuropathy was made. The patient was operated with carpal tunnel release and total tenosynovectomy. Histopathology showed features suggestive of Koch’s etiology. The patient was started with antitubercular therapy (ATT) and followed up regularly. Carpal tunnel symptoms subsided immediately after surgery and there was no recurrence of swelling at the last follow-up. Carpal tunnel release and tenosynovectomy should be performed at the earliest possible and followed up with ATT for better outcomes in tubercular tenosynovitis of the wrist with CTS.

IntroductionCampanacci Grade III Giant Cell tumors of the distal radius are difficult to manage as they are associated with a high recurrence rate. Wide excision of the distal radius and reconstruction with an ipsilateral proximal fibula or ulnar translocation reduces the recurrence rate significantly and gives acceptable function to the hand and wrist. Methods and materialsThis was a retrospective study of eight patients with Campanacci grade III giant cell tumors of distal radius treated with wide excision of distal radius followed by reconstruction at our institute. Four cases were operated on with ulnar translocation and four cases were operated on with ipsilateral proximal fibula grafting after wide excision of the distal radius. Patients were studied for the Musculoskeletal Tumor Society (MSTS) score and visual analogue scale (VAS) score for pain at one year, recurrence, and complications. ResultsThe mean MSTS score of the total series was 24.75 ± 1.6. The mean VAS score for the total series was 1.62 ± 0.4. Of the eight cases, two cases had a recurrence, one patient had persistent wrist paint, and two patients had wrist subluxation. ConclusionWide excision of the distal radius followed by reconstruction with a proximal fibula or ulnar translocation is a good option to avoid repeated surgeries in patients with Campanacci grade III giant cell tumors of the distal radius and achieve acceptable functional results for the wrist and hand.

Introduction: Amputation is a painful functional experience and optimal rehabilitation of an amputee is a team effort. Functional restitution depends on many factors including the type of prosthesis available. We report our experience of providing advanced artificial limbs at free of cost to the underprivileged through a state-sponsored pilot initiative. Material and methods: This is a retrospective cohort study of amputees who have been rehabilitated with advanced artificial limbs through the Department of Orthopaedics at Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India from the years 2017 to 2021. Prostheses were procured through rate contract and monitory support was provided by the state. Evaluation, fitment and functional restitution were supervised by the orthopaedic surgeons to the utmost satisfaction of the amputees. Results: A total of 136 subjects received 142 advanced artificial limbs. Out of 136 subjects, 130 received unilateral and 6 subjects received bilateral prosthesis. Ninety-two percent (n  =  125) were men and 8% (n  =  11) were women. Eighty-eight (n  =  125) were lower limb prosthesis and 12% (n  =  17) were upper limb prosthesis. All the amputees fitted with advanced artificial limbs were highly satisfied at the end of the procedure and were confident of independent living. Conclusion: Appropriate rehabilitative measures are required for amputees to lead an independent life. Paucity of institutional support and monitory challenges preclude them from advanced prosthesis. State-sponsored, institute-based supply of advanced artificial limbs at free of cost to the beneficiaries is a replicable and feasible option for optimal rehabilitation of amputees with appropriate prosthesis.