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Besides standard wound care management the patient received 40 sessions of hyperbaric oxygen treatment (HBO), at 2.4 ATA, 2?h each, in a multiplace chamber. The wound showed a gradual progress towards healing over the course of HBO treatment and achieved a good granulating base at the end of 3?months, whereafter it was closed by primary intention (figure 2). On examination, the length, width and depth of the wound were 20?cm, 10?cm and 2.5?cm, respectively. The wound base was granulated and not infected as evidenced by wound culturing. Figure?1 A large deep non-healing radiation injury over the left scapula. Figure?2 Primary closure of the wound following the achievement of a good granulating base. Radiation exposure may, more frequently in the long term, cause severe injuries to the afflicted tissues, due to a phenomenon usually termed as fibroatrophic effect. According to this dictum, beside vascular alterations, severe fibrosis and cellular depletion account for the morbidity and mortality observed following irradiation.1 HBO has been widely used for various kinds of radiation injuries including soft tissue radionecrosis for almost three decades.1 HBO enhances neo-vascularisation both through angiogenesis and vasculogenesis and also relieves fibrosis by improving the oxidative stress imbalance through enhanced production of antioxidants.1 HBO may be a potential adjunct to standard wound care in the management of radiation-induced injuries. Learning points Wound healing is compromised in irradiated tissues. Hyperbaric oxygen treatment may be a potential adjunct to standard wound care in the management of radiation-induced soft tissue injuries. Footnotes Competing interests: None. Patient consent: Obtained. Provenance and peer review: Not commissioned; externally peer reviewed.""A 23-year-old man was involved in a head-on Tryptophan synthase collision with another vehicle at a combined speed estimated at 200?km/h (kph). The incident occurred just after midnight. The occupant of the other involved vehicle sustained fatal injuries at the scene of the collision. The 23-year-old man was taken to Accident & Emergency (A&E) by ambulance and was assessed by the A&E team in accordance with Advanced Trauma Life Support protocols. After primary and secondary survey and radiological investigation, he was found to have sustained an isolated fracture of the lateral process of his right talus (figure 1). He was admitted under the care of the Orthopaedic Trauma team and was scheduled for open reduction and internal fixation (ORIF) of his fracture. Figure?1 Mortise and lateral radiographs of ankle at presentation showing fracture of the lateral process of the talus.