Biomedical subjects
Publications and source records attributed to D Rouge.
The authors describe a personal otoplasty technique based on several well known methods. This simple technique is performed as an outpatient procedure without chondrotomy, allowing controlled adjustment of the correction regardless of the type of deformity and ensures reliable long-term results. After describing the various steps of the operation, the authors present the rare complications which may occur.
Our experience with over one hundred burned hands has shown that the compartment syndrome is a frequent occurrence in the hand and fingers. It is often underestimated because clinical diagnosis is difficult and an infra-clinical ischaemia may exist although the pulse is present. We believe it is important to carry out systematically Whiteside's method of investigating pressure in the compartments of the hand. When pressure exceeds 40 mm Hg the interosseous compartments and sometimes the digital canals or even the antebrachial compartment should be opened. This simple technique followed by early excision and graft and intensive rehabilitation has in our experience transformed the prognosis of burned hands.
The authors present their experience of the use of carbon dioxide laser for the treatment of angiodysplasias (so-called "cavernous" angiomas). The reduction of operative haemorrhage and the simpler postoperative course resulting from the intraoperative and postoperative use of this technique have ensured very satisfactory results in a series of 76 patients. The limitations of the technique are defined. The authors also discuss the complex classification of "cavernous angiomas" and propose a synthetic clinical approach by combining the embryological, histological, evolutive and radiographic features of these lesions.
The authors report a case of cutaneous pathomimesis of the hand with severe self-mutilation, contrasting with the minimal nature of the psychiatric illness. They recall several pathogenic and therapeutic elements for this disease which, although difficult, should be managed by a multidisciplinary approach.
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Eleven cases are reported of island flaps containing only venous pedicles. All but two survived completely without arterial input and all the successful cases were on the extremities. The possible reasons for this are discussed.
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The authors have shown both in patients and in cadavers that the posterior triquetro-lunate ligament plays a major role in the stability of the carpus. They suggest a new concept associating pronation and dorsal flexion of the wrist, the hand being immobilised, to explain instability following perilunate dislocations with fractures of the scaphoid. They recommend both the fixation of the scaphoid fracture by a screw and primary repair of the triquetro-lunate ligament.
Dermatofibrosarcoma protuberans is a soft tissue, low-grade malignant tumor. Histologically, the tumor is a low-grade sarcoma with a constant storiform growth pattern. The tumor may possibly arise from histiocytes, a thesis supported by recent tissue culture and electron microscopic studies. Treatment consists of the wide local excision. Conservative excision often results in recurrences. Lymph node and other distant metastases, although rare, have been documented. Most often, the clinical course shows this tumor to be slow growing and often painless. Presented herein is a patient in whom this uncommon tumor developed.
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With physical examination alone it is difficult or even impossible to evaluate the abdominal wall damage in patients with major evisceration, especially when they are obese. Computerized tomography (CT) is very useful in this respect as it provides a detailed anatomical overview of the lesions. CT was performed in 30 out of 229 patients operated upon. It supplied information on the size, site and extension of eviscerations and showed whether they were single or multiple; it also informed on the quality, thickness and retraction of the abdominal muscles. All this is extremely important to know before surgery as it enables the operative problems to be foreseen and, to some extent, the operative procedure to be determined. In all cases of complex evisceration CT may be regarded as the "key examination".