We report a case of a 59-year-old female who presented in the general orthopaedic clinic with triggering of her right middle finger. She did not respond to conventional treatment methods; subsequently she underwent surgical open release under local anaesthesia. Five months postoperatively, the patient presented with signs and symptoms of acute flexor tenosynovitis, and was thought to have a postoperative infection. Re-examination by a hand surgeon raised the possibility of a different aetiology. Based on clinical findings and response to initial treatment, giant cell tumour of the flexor tendon sheath was suspected and later confirmed following surgical biopsy. A high index of suspicion and knowledge of the variegated presentations of giant cell tumour in the hand are beneficial in these types of cases.

Palmaris longus is a dispensable muscle with a long tendon which is very useful in reconstructive surgery. It is absent 2.8 to 24% of the population depending on the race/ethnicity studied. Four hundred and fifty healthy subjects (equally distributed among Malaysias 3 major ethnic groups) were clinically examined for the presence or absence of palmaris longus. This tendon was found to be absent unilaterally in 6.4% of study subjects, and bilaterally in 2.9% of study participants. Malays have a high preval

Secondary metastases to the hand are rare, accounting for 0.1% of all metastases, and commonly involve bones 1,2. Soft tissue involvement is extremely unusual although it is significantly more common in carcinoma than sarcoma. Metastatic lesions of adenocarcinoma of the rectum to the liver, lung and vertebrae are well known. Here we report an unusual site of metastatic deposit of primary adenocarcinoma of the rectum to the soft tissues of the wrist causing carpal tunnel syndrome, which if correctly diagnos
Orthopaedic