Küntscher intramedullary nail (K-nail) proximal migration in the femoral medullary canal is a common postoperative complication. But spontaneous distal migration of the K-nail across the knee joint and protrusion over the tibia till the tibial tuberosity is a complication that has very rarely been reported in the literature previously. This is the case report of a 41-year-old man who presented with a pus discharging sinus over the tibial tuberosity for the last one year. Knail insertion was done six years ago. The underlying cause of the migration of the K-nail is subject to controversy and speculation. Infection and delayed union with shortening are some etiological possibilities. Wrong selection of K-nail size, loosely fitted nail, premature weightbearing, and disuse osteoporosis may also be contributory factors.
Giant cell tumour of bone accounts for 5% of all primary bone tumours. Multicentric giant cell tumour is an infrequent variety be it either synchronous or metachronous accounting for less than 1% of all giant cell tumours. Synchronous multicentric giant cell tumour of foot and ankle with epiphysiometaphyseal origin is unheard of. We delineate a case of soap-bubble appearance lytic lesions at left distal tibia and talus in an early adolescent woman with biopsy proven giant cell tumour for its rarity and its successful management by extended curettage and allogenic impaction bone grafting.
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