Susuk: Mysterious incidental finding

Abstract

A 66-year-old Malay lady presented to the orthopaedic clinic with complains of body weakness and pain over her left shin. Her problem started 8 years ago after sustaining an open fracture of the left tibia due to an industrial injury. She was initially managed in a hospital where she undergone wound debridement and external fixation of the fracture. This was followed by open reduction and plating of the left tibia. Her recovery was complicated with osteomyelitis. Throughout the course of treatment, she refused further surgical intervention and eventually defaulted her follow-up. She ended up using complimentary and alternative treatment for her condition. In the orthopedic clinic, she appeared well and ambulating with the help of a walking frame. On assessment, her vital signs were stable. There were old healed surgical and sinus scars over the lateral and medial aspect of her leg. There was also tenderness over the lateral aspect of her leg with mobile fracture site. Her foot was normal. Neurological assessment performed was normal. Radiographs were performed in view of her pain and previous surgical complication (Fig. 1a–c). Fig. 1 (a) Antero-posterior radiograph of the left leg. (b) Lateral radiograph of the left leg. (c) Oblique and antero-posterior radiograph of the right foot.