Pyoderma Gangrenosum Affecting the Dorsal Hand: A Case Report.

Pyoderma gangrenosum is an uncommon neutrophilic dermatosis characterized by an ulcerative lesion with a violaceous border. Most frequently, these lesions present in the lower extremity and are associated with underlying immune-mediated comorbidities. Infrequently, these lesions may present in the upper extremity, which presents difficult challenges for upper extremity surgeons as the lesions are frequently misdiagnosed as an infectious process.

Distraction osteogenesis following low-dose hyperfractionated irradiation in the rat mandible.

Purpose: The investigators hypothesized that low-dose hyperfractionated radiation would impair mandibular distraction osteogenesis (DO) in a murine mandibular model.

Materials And Methods: Male Sprague-Dawley rats underwent fractionated radiation (30 Gy) of the left mandible. After a 2-week recovery period, an external frame distractor was applied and gradual distraction of the mandible was performed.

The effects of high dose and highly fractionated radiation on distraction osteogenesis in the murine mandible.

The ability of irradiated tissue to support bony growth remains poorly defined, although there are anecdotal cases reported showing mixed results for the use of mandibular distraction osteogenesis after radiation for head and neck cancer. Many of these reports lack objective measures that would allow adequate analysis of outcomes or efficacy. The purpose of this experiment was to utilize a rat model of mandibular distraction osteogenesis after high dose and highly fractionated radiation therapy and to evaluate and quantify distracted bone formation under these conditions.

A cost-utility analysis of nonsurgical management, total wrist arthroplasty, and total wrist arthrodesis in rheumatoid arthritis.

Purpose: Management of end-stage rheumatoid wrist disease remains controversial. Total wrist arthrodesis provides reliable pain relief and stability and is the most commonly applied management strategy. Total wrist arthroplasty is a motion-preserving alternative that is gaining popularity.

Reconstructing the rheumatoid wrist: a utility analysis comparing total wrist fusion and total wrist arthroplasty from the perspectives of rheumatologists and hand surgeons.

Rheumatologists and hand surgeons have historically demonstrated strikingly divergent attitudes toward the benefits of surgical intervention, either total wrist fusion or total wrist arthroplasty, for the rheumatoid wrist. A utility analysis was conducted to compare a national random sample of hand surgeons and rheumatologists regarding their opinions about surgical management of severe rheumatoid wrist disease. A web-based trade-off utility survey was developed, and participants were presented with survey scenarios comparing well-controlled rheumatoid arthritis with operative and non-operative management.

Total wrist arthroplasty and total wrist arthrodesis in rheumatoid arthritis: a decision analysis from the hand surgeons' perspective.

Purpose: Treatment of severely destroyed rheumatoid wrists with total wrist arthroplasty or total wrist arthrodesis relies on patient and surgeon preferences rather than rigorous prospective outcomes data. The purpose of this study is to develop a decision analytic model of arthroplasty and arthrodesis in rheumatoid arthritis (RA) using utility values obtained from a random sample of hand surgeons.

Methods: A utility survey using a time trade-off design was administered to 175 members of the American Society for Surgery of the Hand.

A systematic review of total wrist arthroplasty compared with total wrist arthrodesis for rheumatoid arthritis.

Background: Management of the end-stage rheumatoid wrist is controversial. The most common treatment is total wrist fusion. Total wrist arthroplasty offers a motion-preserving alternative.

Mandibular distraction in the absence of an ascending ramus and condyle.

The introduction of distraction osteogenesis (DO) as a method of mandibular elongation has provided the craniofacial surgeon with a valuable tool in the approach to patients with mandibular deficiencies. A growing number of case reports and clinical series have proven the efficacy of mandibular DO as an augmentative technique in patients with hemifacial microsomia (HFM). Although DO has become a part of the treatment algorithm for many patients with HFM, surgeons have been reluctant to apply the technique in patients with complete agenesis of the ascending mandibular ramus and condyle (grade III HFM).