Thrombosis in the upper limbs is a rare condition. We report on a case of subclavian artery thrombosis that occurred following open reduction and internal fixation of fracture in the middle third of the left clavicle. This is difficult to diagnose and requires a high index of suspicion. Early recognition can prevent fatal thromboembolic complications and disability.

Rationale: Fibroma of tendon sheath is a rare benign tumor that is attached to the tendon sheath. Patient concerns: A 16-year-old boy presented with a painless mass in his right foot, which was initially misdiagnosed as a giant cell tumor of the tendon sheath. Diagnosis: Fibroma of tendon sheath, which exhibited radiographic features similar to those of giant cell tumor of tendon sheath. Excisional biopsy demonstrated spindle-shaped cells and collagen-like stroma. Interventions:The patient underwent excision biopsy. Outcomes: The patient recovered well and showed no signs of recurrence at 6-month follow-up. Lessons: This case provides valuable insights for foot and ankle surgeons. While radiological investigations are helpful in many diseases, histological examination is indispensable for establishment of the final diagnosis. Abbreviations: FTS = fibroma of tendon sheath, MRI = magnetic resonance imaging. GCTTS = giant cell tumor of tendon sheath.

Chronic osteomyelitis of any bone is a difficult condition to treat once it sets in. Various modalities of treatments are available for osteomyelitis. Here we present a case of an infected tibia with intramedullary nail in situ. This was initially treated by removing the intramedullary nail and IV antibiotics, followed by packing of medullary canal of infected tibia with BIODEGRADABLE ANTIBIOTIC COATED BEADS. Outcome was studied.

Unstable intertrochanteric fractures in elderly patients pose a challenge for treatment in view of coexistent medical problems and osteoporosis. Osteosynthesis in these group of patients often leads to implant failure and also does not allow early weight bearing. The objective of the present study is evaluate Arthroplasty as primary treatment of choice in these unstable intertrochanteric fractures in elderly. Methods: Between January 2013 to Feb 2016, 25 elderly patients with unstable intertrochanteric fractures who had undergone arthroplasties (Hemi/THR) were followed up. Their fractures were classified according to the AO/OTA classification and their osteoporosis was evaluated by Singh's index and graded accordingly. After optimization of medical problems and pre-anesthetic workup, Arthroplasty was performed in all patients and the outcomes analyzed using the Harris hip score system. Results: In these 25 patients, 17 were women, 8 were men and the mean age was 76 years (range, 68-88 years). At a mean follow-up of 1 year (range, 1-3 years), there were 18 excellent, 5 good, and 2 fair results according to the Harris hip score system. Conclusion:In select elderly patients with unstable intertrochanteric fractures arthroplasty has a role instead of Osteosynthesis which allows early pain free mobilization of patients, thereby avoiding revision surgeries, prolonged morbidity and uncertainty associated with Osteosynthesis.

Wound infections in orthopaedic practice needs early attention and rapid management. Especially with implants in situ needs aggressive treatment, to avoid complications leading to implant failure. Hence thorough wound debridement should be done for patients which may lead to difficult closure or raw areas. Soft tissue injuries along with fractures are also more common in orthopaedic practice, which may further require grafting in future. Here we present 22 patients from our hospital from year may 2017 to may 2018 in whom we used vacuum assisted closure in patients who had wound infections with implants in situ and also in patients with extensive soft tissue infections with fractures. Thus we found Negative pressure wound therapy plays a significant role in orthopaedic practice as it decreased time of hospital stay promoting faster healing of wounds by shrinkage of wound size and decreasing infection rates.