Introduction: Windblown hand or congenital ulnar drift of hand is a rare deformity which affects all the digits including the thumb and can lead to functional impairment. Associated syndromes affecting the head, face, and feet should be ruled out. Windblown hand has three main features: (1) Contracture of the fingers with flexion deformity, (2) adduction contracture of the thumb causing narrowing of the first webspace, and (3) ulnar deviation of the fingers at the metacarpophalangeal joint. Early treatment is effective. Methods: We performed surgical correction in three cases of bilateral windblown hands. The extensor digitorum tendons were repositioned over the metacarpophalangeal heads by longitudinal plication of radial sagittal bands. In one case, skin contracture release for the first webspace was also done. Splinting with radial deviation and extension at metacarpophalangeal joint was done for 3 weeks. The average follow-up time was 6 months. Results: No skin necrosis or infection was seen in postoperative period. The patient satisfaction ranged from very good to excellent. For all the patients, first, the nondominant hand was operated, then all opted for surgical correction of the opposite hand as well. Conclusions: Windblown hand can lead to functional impairment and needs early correction. Parents and patients should be counseled about the chances of recurrence and incomplete correction. However, surgical treatment and subsequent physiotherapy can improve the functional range and aesthetics of the hand.

Objective: We assessed the relationship between serum 25 hydroxyvitamin D (OH) D levels and the presence of malignancy in patients who underwent surgery for cutaneous skin lesions. Materials and Methods: Three-hundred and ninety-eight patients operated on for cutaneous lesions, had serum 25 (OH) D levels on file, had no known parathyroid pathology, did not concomitantly take bisphosphonate or Vitamin D supplement, and had accessible pathology results were reviewed upon their consent for the retrospective analysis of their data. Demographic characteristics, diagnosis dates, lesion localizations, pathology results, and serum 25 (OH) D levels were noted. Optimal cutoff value for Vitamin D levels was calculated with receiver operating characteristic (ROC) curve analysis and pathology results of the excised lesions and patient characteristics were analyzed according to this value. Results: ROC analysis showed 90% sensitivity and 64% specificity for vitamin D levels of 18.64 ng/ml (area under the curve [AUC] = 0.905; 95% confidence interval 0.87–0.93, P < 0.001). Review of lesions for pathological characteristics showed 207 (52%) benign and 191 (48%) malignant. While no significant relationship was observed between gender and vitamin D levels, a significant difference was identified between advanced age and low Vitamin D levels and the presence of malignancy (P < 0.001). The one-way analysis of variance and Bonferroni's post hoc analysis revealed higher incidences of malignant lesions in the group with low serum 25 (OH) D levels (P < 0.001), in patients aged 65+ years (P < 0.001), in cases localized to the head and neck (P = 0.026), and in males (P = 0.047). Conclusion: We identified a statistically significant relationship between low serum 25 (OH) D levels and the development of cutaneous malignancy.

Background: Postburn flexion contractures of the knee may arise even with adequate treatment of the burn injury. Pedicled medial sural artery perforator (MSAP) flap has been described for the reconstruction of defects of the knee and proximal third of the leg. Its use in the management of postburn contracture release is sparse. We are presenting the use of a medial sural artery pedicled flap for the reconstruction following postburn knee contracture release. Materials and Methods: This study included six patients with postburn unstable scars and a mild degree of knee contractures who underwent release of the contracture and coverage using MSAP pedicled flap. The results in terms of flap size, recurrence, complications, functional outcome, and cosmesis were assessed. Results: The flap size ranged from 7 cm × 6 cm to 13 cm × 7 cm with a mean pedicle length of 9.41 cm. All six flaps survived without any complications with a satisfactory outcome. The patients were followed up for 6–18 months. There was no recurrence of contracture without any restriction of knee joint mobility. Conclusion: MSAP flap is a reliable flap and should be considered for the management of postburn knee contracture of grade 2 and grade 3 contractures, as it provides optimum and ideal coverage with fewer chances of recurrence.

The traditional two-flap palatoplasty technique described by Veau-Wardill-Kilner is a two-flap palatoplasty suggests a posterior pushback movement of flaps should require an intact pedicle. Even a proper dissection of greater palatine vessels is done, some sort of tension burdens on the flaps due to the traction of the pedicle is inevitable. In addition to that, the right-angled flexion of the pedicle at the posteromedial bony corner of foramina palatinum majus diminishes blood flow. Particularly, in wide clefts, tight approximation of flap compromises the wound healing and resulting fistulas. A segmental bone resection from posteromedial wall of foramen palatinum majus as an outfracturing fashion is performed to assist a tension-free cleft palate repair. The more release of the pedicle from its hole loosens the flaps. It provides an easy posteromedial transposition of tissues. This maintains also most push-back movement of flaps.

Bizarre parosteal osteochondromatous proliferation (BPOP) is a rare lesion that usually arises in short bones of the hand and feet. It is typically seen in the third and fourth decades, seldom seen in the pediatric age group. A 6-year-old girl was presented with swelling over the ring finger of the left hand. The radiograph showed ectopic calcification and periosteal reaction in the ring finger. Computed tomography was performed, and a BPOP diagnosis was made on the preoperative finding. Excision of the lesion with overlying pseudocapsule and decortication was performed with a piezoelectric device. The patient is currently in a routine follow-up without recurrence. There is not enough data for treatment and follow-up BPOP in pediatric patients. The present case would contribute to the literature in the management of this rare presentation.

Necrotizing fasciitis (NF) is a rare, rapidly progressive infection with high mortality rates. Foreign body is one of the most common etiologic factors for NF. Soft tissue fillers are foreign bodies which are used for a number of indications by clinicians and nonclinicians. Besides the products approved by the Food and Drug Administration many materials such as vegetable oils are used as fillers. Herein, we evaluated an unusual case with NF due to olive oil injection together with a cloud of literature.

A 63-year-old woman applied to us with a complaint of ecchymosis on the left half of her face and left subconjunctival hemorrhage after talking on her cell phone. There was no history of trauma or known medical diseases, but the patient had multiple endosteal implants, nine of them from 12 years ago, and a recent one on her left maxilla from last year. After detailed anamnesis, it is learned that the patient was not using any bisphosphonate treatment, but she was on Vitamin D treatment due to Vitamin D deficiency and using mirtazapine and alprazolam for anxiety. However, her T-score calculated for osteoporosis was above −2.5. All of the maxillofacial examinations were normal except for suspicious step deformity in the palpation of the left infraorbital rim. However, on the computed tomography imaging, it showed that there were fractures on the left lateral and infraorbital wall and left inferior maxillary sinus wall. MRI imaging ruled out any possible fracture caused by an aneurysmal bone cyst. With all these findings and careful examinations, the cause of these fractures was considered a late complication of her dental implants.