[Costochondral autograft as a salvage procedure after failed trapeziectomy in trapeziometacarpal osteoarthritis]. / Autogreffe de cartilage costal après échec d'une trapézectomie-ligamentoplastie.

We report the case of a 48-year-old woman who underwent a revision procedure to insert a costochondral autograft after failed trapeziectomy-ligamentoplasty. Clinical outcome was assessed at 3, 6, 12, and 24 months and compared with the preoperative situation. Pain (VAS), force (key pinch and grasp), writing capacity, use of an ignition key, and range of motion of the trapeziometacarpal joint in abduction and opposition were noted. The VAS demonstrated improvement in pain and the patient was able to use an ignition key but grasp force and joint range of motion remained unchanged. There was no complication at the graft harvesting site. This technique appears to be a useful salvage method after failed trapiezectomy.

[Port wine stains or capillary malformations: surgical treatment]. / Traitement chirurgical des malformations capillaires.

Capillary malformations do not demand mostly any therapeutics. For aesthetic reasons, family or child can demand a treatment to ease even to remove the unsightly character of the lesion. In this context, the means employees must be simple and not engender aftereffects more unaesthetic than the lesion. The pulsed dye laser fulfils perfectly this conditions by improving the color of the lesion without touching the texture of the skin. However it's a treatment requiring many sessions over 2-3 years. Surgery keeps an interest for the treatment of capillary malformations resistant to laser (in particular on the limbs) or to treat soft tissues hyperplasia met in certain cervicofacial locations. The surgery uses the whole techniques of plastic surgery classified from the most simple to the most complicated: excision-suture in one time or iterative, excision and coverage by a skin graft, use of skin expansion techniques with local flaps.

[Indications of lasers treatment for lymphatic malformations]. / Indications des lasers dans le traitement des malformations lymphatiques.

Cutaneous dermatologic lesions of LM, in type of superficial, translucent, localized or diffuse vesicles, are accessible to laser treatment. The useful lasers are essentially laser CO(2), and rarely pulsed dye laser and the Nd: YAG. Treatment by laser allows to obtain the ablation of vesicles by limiting aftereffects (scare) and so to dry up the transcutaneous lymphatic liquid. However laser has no action on the deep constituent of the LM and it's why medium and long term recurrences are inevitable. Finally, the indication of the laser must be retained only as a supplement to the surgery and has to be done by experimented persons.

[Facial rejuvenation: rationale use of lasers and thermal systems]. / Le rajeunissement du visage: techniques de complément ou de substitution à la chirurgie. Apport des lasers et systèmes à effets thermiques.

The methods additional or substitution for the surgery of facial skin ageing are dramatically rising before 40 years. These methods are addressed more to the wrinkles and others signs of aging skin. They can constitute a door of entry in the aesthetic treatments and needs a professional approach. These noninvasive methods (within the meaning of the incision) can present complications this the more so as the tendency is with the vulgarizing and with under considerations of the initial diagnosis and the treatment itself. The devices of thermal effects consist of lasers, pulsed flashlamps and radiofrequency. The objective of this development is to consider the bonds, which link the initial diagnosis and the proposal for a treatment by considering side effects and complications of each method.

[Complications of the resurfacing laser: retrospective study of 749 patients]. / Complications du relissage laser: une revue de 749 patients.

BACKGROUND: Resurfacing laser is one of the alternative treatment for cutaneous facial rejuvenation. Results are mainly good to excellent, but complications do occur with variable frequency. OBJECTIVES: The purpose of this study was to identify and report the complications they occurred during eight years laser resurfacing and to study their possible avoidance. The author experiences are discussed in conjunction with a review of published reports. METHODS: A retrospective analysis and chart review was performed in 749 patients who underwent cutaneous laser resurfacing with CO2 and Erbium laser by a single operator. Side effects and complications relating to infection, postoperative healing, pigmentary changes, and scarring were tabulated. RESULTS: The most common complication observed was postoperative erythema, which occurred in all patients. Hyperpigmentation was seen in 32% of patients and must be precociously treated. Dermatitis occurred in 10.6% of patients. Hypopigmentation and infections are rare (<1%). CONCLUSION: Although laser resurfacing is a safe and effective method of facial rejuvenation, the cosmetic surgeon must be aware of the various complications that may be encountered. Prompt recognition of complications and appropriate management provide the best opportunity for an acceptable aesthetic outcome.

Distance education and caregiver support groups: comparison of traditional and telephone groups.

OBJECTIVE: To implement and evaluate the impact of telephone caregiver groups, compared with traditional face-to-face, on-site caregiver groups. DESIGN: Quasi-experimental design comparing the two group types across time. SETTING: An urban tertiary rehabilitation hospital with a brain injury program servicing a vast geographical area. PARTICIPANTS: Caregivers of an adult person with a brain injury participated in either one of the 10 telephone groups (TGs) (N = 52 caregivers who completed a full set of research forms) or one of the 10 on-site groups (OGs) (N = 39 caregivers who completed a full set of research forms). The combined total from both groups was 91. INTERVENTION: Caregivers who lived within 40 km of the facility were placed in one of the OGs, and all others were placed in one of the TGs. Both types of groups met weekly for 9 to 10 weeks and were led by either social work or psychology professionals. The TGs met using teleconference technology. MAIN OUTCOME MEASURES: Profile of Moods States (POMS), Caregiver Burden Inventory (CBI), and the McMaster Model Family Assessment Devise (FAD), were administered 2 months before the first day of group, on the first day of group, on the last day of group, and 6 months after group. On the last day of group, a participant satisfaction survey was administered. RESULTS: There were similar amounts of improvements for the outcomes from OGs and TGs. Rural caregivers had fewer difficulties on all measures at all measurement intervals. In both types of group, participants showed a statistically significant improvement in POMS scores and a trend toward improvement in FAD and CBI results. Participants of both group types rated their experience highly, although rural caregivers were somewhat more satisfied. CONCLUSIONS: Telephone groups offer a method of providing support and education to rural caregivers that is as effective as traditional in-person OGs.