Methylmetacrylate (PMMA) cranioplasty technique: Technical interest of intraoperative modeling and review of the literature.

Reconstruction of bone loss in the cranial vault may be necessary for functional or aesthetic reasons following trauma, decompression craniectomy, or craniofacial malformations. Many techniques have been described in the literature, using various materials, each with its own advantages and drawbacks. Reconstruction with polymethylmetacrylate cement has the advantage of a durable result and relative ease of use. In this article we present our cement cranioplasty technique through 4 clinical cases of cranial vault reconstruction, by direct intraoperative modeling on the bone defect. This accessible, effective method, applicable to all sizes of defect, remains an attractive option in the arsenal of techniques available today.

Medical and surgical management of lower extremity war-related injuries. Experience of the French Military Health Service (FMHS).

Lower extremity war wounds are characterized by high-energy trauma occasioning loss of complex and pluritissular substances. The support pipeline put into place by the French defense health service (SSA) is designed to rapidly evacuate the injured person from the scene of injury to mainland France, following initial surgery in the framework of a sequential tactic known as "Damage Control Surgery". This strategy is aimed at stabilizing the traumatized individual and enabling his evacuation. Patients are subsequently treated in a restorative surgery unit in a Hôpital d'Instruction des Armées (HIA), a level 1 trauma center (HIA Percy, HIA Saint-Anne) Cooperation between the plastic and orthopedic surgery specialties is essential insofar as it allows for surgical optimization aimed at saving the limb while restoring function to the greatest possible extent. Notwithstanding painstaking application of this common strategy, septic pseudoarthrosis remains the principal and most feared complication, at times rendering impossible any therapeutic solution other than amputation. Whether prosthetic or non-prosthetic, the rehabilitation provided by doctor/physiotherapists is conducive to patients' social and professional reintegration. The nation's duty to assist its wounded veterans is carried out with determination by the French defense ministry. As concerns lower extremity war wounds, the authors detail the reconstruction doctrine based on the 6/7/8/9 rule, in accordance with which strategies for repair of soft tissue and reconstruction of the lost bone substance have been developed.