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Ewings sarcoma of the hand is relatively rare. Ewings sarcoma can present with minimal pain and swelling of the affected digit. The Erythrocyte sedimentation rate and C-reactive protein may be high. Radiologically, Ewings sarcoma can present with a plethora of features from permeative bone destruction to expansile lesions with or without periosteal reaction. Because of these features, this can be confused with Tuberculosis especially in a country like ours where Tuberculosis is endemic. This leads to starting of inappropriate treatment and delay in diagnosis. We report a case of an 18 year old boy who was initially diagnosed as Tuberculous dactylytis of the proximal phalanx of the little finger. He was started on anti-tuberculous treatment and did not respond to it. Subsequent investigation in our centre which also included an open biopsy, confirmed the diagnosis of Ewings sarcoma. He was treated with ray excision, and chemotherapy. This case is being presented for its rarity and also to emphasize the fact that an open biopsy in suspected cases would be appropriate to confirm the diagnosis. This would prevent delay in diagnosis of rare conditions like Ewings sarcoma.

Purpose.To evaluate outcome of 6-strand triple Kessler repair for flexor tendon injuries, followed by early active motion rehabilitation. Methods. 25 men and one woman (36 fingers) underwent 6-strand triple Kessler repair for flexor tendon injuries in zones 2 to 5, followed by early active motion rehabilitation. Rehabilitation was started at days 3 to 5. Patients were instructed to passively flex all the fingers with the uninjured hand and to actively retain this position for 10 seconds. Active extension within the confines of the splint was allowed. At the end of week 8, strength training was commenced until a satisfactory range of motion was regained. Outcome measures included total active motion, grip strength, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Complications such as infection and wound dehiscence were recorded. Results. The mean follow-up was 1.2 (range, 1-2) years. Outcome was excellent in 24 digits, good in 4, and poor in 8. The mean grip strength was 80%Early active motion protocol following triple Kessler repair for flexor tendon injury S Rajappa, PG Menon, M Mohan Kumar, D Gokul RajDepartment of Orthopedics and Hand surgery, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India Address correspondence and reprint requests to: Dr S Rajappa, B2 Clinic, Sri Ramachandra Medical Centre, Porur, Chennai, Tamil Nadu, 600 116, India. Email: chickko2002@yahoo.com Surgery 2014;22(1):96-9 (range, 60-100%) of normal in dominant hands and 60% (range, 50-65%) of normal in non-dominant hands. The mean DASH score was 15 (range, 0-52). One patient had wound dehiscence and superficial infection. Conclusion. Six-strand triple Kessler repair for flexor tendon injuries, followed by early active motion rehabilitation yields satisfactory results. Journal of Orthopaedic

Osteochondromas are the most common benign bone tumours and account for 20 to 50% of benign bone tumours and 10 to 15% of all bone tumours. They usually occur in long bones; 40% occur around the knee joint, but in the hand they are uncommon and usually affect the proximal phalanx. The metacarpal is rarely involved. We report a 32-year-old man with a recurrent solitary osteochondroma of the metacarpal.

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