We report on a case of glomus tumor in the right thumb. The tumor had a 2-year clinical history. The patient reported the development of a 3-5mm tumor in the distal phalangeunder the nail of the right thumb. The patient also complained of severe and progressive pain. Tests using bidirectional Doppler and echo-color-Doppler revealed a presumptive diagnosis of arteriovenous malformation based on the turbulence of the flow and absence of stenosis. The tumor was removed by open surgery and sent for histopathological examination, which showed a diagnosis of glomangioma. The present report describes a rare disease causing extreme discomfort to the patient, which may be treated with surgical resection without sequelae.
Purpose:To treat delayed present (more than 24h) and Gustilo type III fractures in a better way than external fixation which before was a routine in our hospital. Methods: We have applied advanced trauma life support control (ATLS). After proper debridement of the wound, irrigation with saline and antibiotic cover, we reduced the fracture with the Sign IM nail, which is a solid nail without internal dead space, and then we added antibiotic loaded cement with 3g of Amikacin and 4g of Vancomycin. Results: Out of 38 delayed present fractures, we have observed serous discharge in 3 cases which have been controlled by changing the antibiotic loaded cement. While the other cases remained uninfected. Conclusion:The best way to deal with infection is to prevent it, while other factors as obesity, diabetes, and other co-morbidities increase the risk of infection. In our method, we also provided local high concentration of antibiotic with the use of cement loaded antibiotic, and the control of dead space with bone defect and tissue loss. If we do not put cement or other solid material, then blood will definitely take space and that would be a media for infection.
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