Murat Uzel

A viral infection of the hand commonly seen after the feast of sacrifice: human orf (orf of the hand).

Orf of the hand is an uncommon zoonotic infection caused by a dermotropic DNA virus that belongs to the Parapoxvirus genus of the family Poxviridae. It is transmitted to humans through contact with infected sheep and goats and is reported as an occupational disease. We report nine cases of human orf seen in the hands of individuals, who were not occupationally exposed, after the feast of sacrifice in Turkey. Three cases were teachers and six out of the nine were housewives. We observed musculoskeletal complications and misdiagnoses. It is important to consider human orf in the differential diagnosis of hand lesions to prevent overtreatment and complications.

Morphometrical features of the human malleolar groove.

Background: Our aim was to investigate the morphometric features of malleolar groove of the lateral malleolus in humans. Methods: This study was performed on the malleolar grooves of 93 (80 dry and 13 cadaveric) fibulae. We measured the length of the fibula; length, width, and depth of the malleolar groove; the angle between malleolar groove and the fibular axis. Furthermore, we measured the distances between the distal tip of the fibula and the lateral and medial tubercles of lateral malleolus, and the width of posterior surface of the lateral malleolus. Results: We found the shape of malleolar groove regularly concave in 63 out of 93 (68%) fibulae. The features of the triangular area at the posterior aspect of the lateral malleolus, where the peroneal tendons pass over, may serve as a bed for the peroneal tendons. There was a significant correlation between the depth of the malleolar groove and the distances between the distal tip of the fibula and the medial and lateral tubercles, as well (p < 0.05). Conclusion: A strong correlation existed between either the shape of the groove or the values of the reference points. Clinical Relevance: The shape of the groove may be important in reinforcing the superior peroneal retinaculum (SPR) and other structures restraining the tendons.

A case of fetal anticonvulsant syndrome with severe bilateral upper limb defect.

Women with epilepsy have a higher risk of having a dysmorphic child. We report on a child exposed prenatally to valproate and carbamazepine presenting with severe bilateral upper limb defect and phenotypic features of fetal valproate syndrome. Anticonvulsant drugs can cause severe birth defects, especially when used in combination.

Correction of buttock ptosis with anchoring deepithelialized skin flaps.

A new technique for correction of a buttock ptosis resulting from a degloving injury is presented. With this technique, the deepithelialized crescent-like zone in lateral thigh redundancy anchored to gluteal fascia through three separate incisions as used for creation of a new gluteal crease. The patient’s satisfaction was good with long-term follow-up evaluation. Infragluteal fold reconstruction is achieved by reconstruction of the buttock’s sustaining apparel through deepithelialized skin flaps anchored to deep gluteal fascia.

Pierre Robin Sequence With Esophageal Atresia and Congenital Radioulnar Synostosis

A wide spectrum of anomalies can be associated with Pierre Robin sequence. This report presents a 3-day-old infant with micrognathia, U-shaped cleft palate, low-set right ear with microtia, glossoptosis, esophageal atresia, and right congenital radioulnar synostosis. The association of congenital radioulnar synostosis and esophageal atresia with Pierre Robin sequence has not been previously described.

Tuberculosis of the Knee in a Child

The diagnosis for skeletal tuberculosis is often overlooked. We report a 9-year-old patient with a history of 2 years of swollen joint, with a diagnosis of tuberculosis of the knee with involvement of the proximal tibial epiphysis, and treated surgically and with anti-tuberculosis drug therapy.

Swan-Neck Deformity and Paresthesia Following Giant Orf

Orf is a zoonotic infection caused by a parapoxvirus that primarily infects sheep and goats. Human orf infection can take place when abraded skin comes into contact with infected animals. It occurs most commonly on the index finger. The characteristic lesion resembles a tumor and resolves spontaneously, usually without any complications. However, rare complications such as lymphangitis, adenitis, erythema multiforme, erysipelas, papulovesicular eruption, Pseudomonas aeruginosa infection, and bullous pemphigoid have been reported. Herein, we report a case of giant orf causing swan‐neck deformity and paresthesia. These complications have not been previously reported in the literature.

Bilateral aplasia of the tibialis anterior and unilateral aplasia of the extensor hallucis longus muscles

A 35-year-old woman presented with bilateral leg pain on walking that had been present since childhood. Clinical examination showed bilateral absence of the tibialis anterior tendons and the left extensor hallucis longus tendon. Magnetic resonance imaging revealed that signal intensities in the location of the tibialis anterior muscles bilaterally and the left extensor hallucis longus muscle were uniformly high on T1-weighted images, consistent with fat tissue and aplastic muscles: findings not previously reported.

Prenatal and Postnatal Findings in a Case with the Autosomal Recessive Type of Robinow Syndrome

Objective: Our aim was to present a prenatally diagnosed case with Robinow syndrome in a consanguineous couple and discuss possible differential diagnosis in view of the literature. Methods: A 28-year-old pregnant woman gravida 2 para 1 was referred to the obstetric clinic of Kahramanmaras Sutcu Imam University presenting with a fetus having shortened upper and lower limbs at 33 weeks of gestation. Her medical history was unremarkable except for consanguinity. Prenatal ultrasonographic examination revealed a reduced humerus and femur length. Further, shortening of the forearm, frontal bossing, mild hypertelorism, reduced thoracic perimeter and hemivertebrae at the thoracic level were present. Results: Meticulous neonatal examination was performed following an uncomplicated vaginal delivery at 39 weeks of gestation. Distinct facial appearance in addition to the prenatal findings argued in favor of the diagnosis of Robinow syndrome. Additionally, radiological survey revealed and confirmed shortening of the upper extremities and thoracic hemivertebrae. Conclusion: We are documenting the case on the account of its rarity and additional features. The main approach in the differential diagnosis of Robinow syndrome should determine whether hemivertebrae is isolated or part of a syndrome or association.

Calcaneal osteomyelitis after puncture wound to foot: case report and review of the literature

Puncture wounds of the foot are relatively common injuries that occur in persons of all ages. A small percentage of puncture wounds becomes infected and can lead to complications such as osteomyelitis, osteochondritis and soft tissue abscess. These wounds must be followed up routinely one week after injury. We report a case of calcaneus osteomyelitis caused by a mixed infection with Escherichia coli and Staphylococcus aureus subsequent to puncture wound of the foot. The characteristics of the patient, the pathogenic organisms, treatment and outcome are presented.