[Characteristics of Dupuytren's disease in women. A study of 67 cases]. / Particularités de la maladie de Dupuytren chez la femme. À propos de 67 cas.

OBJECTIVES: The aim of this study was to identify the clinical differences of the Dupuytren's disease in gender. Testosterone induces an increase of the Dupuytren's fibroblast proliferation via androgen's receptors. Testosterone rate increases during pregnancy and menopausis. We also reached a link between this factors and the clinical aspects of Dupuytren' disease in the women of our study. METHODS: This retrospective, comparative study was about all women and a randomized number of men, who underwent surgery for Dupuytren' disease between 1980 and 2010. We analysed all the epidemiologic and clinical data, the surgery procedures and the complications. Pre- and postoperative measurements of the extension lack of all the joints were performed with a manual goniometer. Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to evaluate the patients function. This specific data of women were reached. RESULTS: Sixty-seven women and 69 men were compared. The complex regional pain syndrome was significantly more common in women and the correction of the proximal interphalangeal joint was significantly lower in women. Recurrence rate and mean follow up were not statistically different. Mean DASH score was higher in women. We have not found any association between menopausis, pregnancy and the average age at presentation of the disease, the recurrence rate or the extension rate. CONCLUSIONS: The prognosis of the Dupuytren's disease is worse in women than in men. Other studies are necessary to reach the link between the testosterone and the clinical history of the disease in women.

[Baropodometric analysis of the functional donor-site morbidity after gastrocnemius or soleus muscle-flap procedure]. / Analyse baropodométrique des séquelles fonctionnelles liées au prélèvement des lambeaux gastrocnémiens et soléaire.

The triceps surae muscle is a major donor-site for muscle-flap to cover soft-tissue defects of the leg. There are very limited datas on the functional donor-site morbidity in the literature. From a retrospective study on 14 patients, we realized a baropodometric analysis comparing the operated lower limb with the healthy non operated side and a functional evaluation by a questionary. The modified functional score of Kitatoka was good (87/100). Ninety percent of the patients were able to resume a professional activity and 2/3 to resume the sport. The baropodometric analysis did not show statistically significant difference of propulsion and absorption between the healthy side and the operated side, but a modification of the programming of the step. The absence of important functional donor-site morbidity is probably bound to a compensation of the remaining triceps surae muscles and/or to mechanisms of adaptation. Our study confirms the little functional donor-site morbidity of the partial triceps surae muscle-flap procedure. These flaps remain a good solution for the coverage of the soft-tissue defects of the leg.

[Fingertip reconstruction with occlusive dressing: clinical results and biological analysis of the dressing content's]. / Reconstruction pulpaire par pansement occlusif: évaluation clinique et analyse biologique du contenu du pansement.

OBJECTIVES: To evaluate the fingertip reconstruction with occlusive dressing and explore the mechanisms and the mediators of this "fingertip regeneration". PATIENT AND METHODS: Nineteen patients who sustained a fingertip injury were treated with occlusive dressing. Two prospective studies: a clinical analysis of the aesthetics and the functional results, a biologic analysis of the dressings in order to search microorganisms, cytokines, and growth factors. RESULTS: Among 15 patients reviewed, the healing was acquired in 2.7 weeks (2.5). The thickness of the fingertip was excellent in 30% and good in 70%. The Weber test was 3.8mm for the fingertip reconstruction against 3mm for the opposite side. The analysis of the dressing exudates brings to light a pullulement of saprophyte bacterium of the skin but also pathologic species, and presence of angiogenic factors (PDGF, VEGF, EGF). CONCLUSIONS: The occlusive dressings remain a reliable and reproducible alternative for treatment of fingertip injuries in zone 1 and 2. This reconstruction seems to depend on bacterium pullulement and cellular growth factors liberation.

[Bilateral latissimus dorsi V-Y musculocutaneous rotation flap for closure of a large dorsal radionecrosis. Geometric analysis and interest. About one case]. / Couverture d'une perte de substance dorsale médiane par deux lambeaux musculocutanés de rotation de latissimus dorsi avec palette cutanée en V-Y. Bases géométriques et intérêt. A propos d'un cas.

Reconstruction of a large dorsal radionecrosis with bilateral latissimus dorsi V-Y musculocutaneous flaps is reported. This procedure provides a reliable, well-vascularized soft-tissue coverage. Geometric analysis and differences between V-Y advancement flap and V-Y rotation flap are discussed.

[Large breast hypertrophy and gigantomastia management by postero-inferior pedicle reduction technique. About 20 cases]. / Traitement des hypertrophies mammaires très importantes et des gigantomasties par la technique de réduction dite à pédicule postéro-inférieur. A propos de 20 cas.

The authors present a retrospective study about 20 patients operated for important breast hypertrophy and gigantomastia by the postero-inferior reduction technique. They compare the results obtained by this technique on the breast (projection, breast-feeding) and on the nipple-areola complex (sensibility, pigmentation, nipple projection), with those obtained by the Thorek technique (free nipple grafting). The authors show that this technique is reliable for such breasts hypertrophies, with good esthetics results, and avoid free nipple grafting.

Spatial and temporal co-structure analyses between ichthyofauna and environment: an example in the tropics.

Ichthyofauna distribution and habitat characteristics of Thalassia beds in the Grand Cul-de-Sac marin lagoon in Guadeloupe were studied during a one-year survey. Environmental variables (9) were measured monthly in ten sites along with collection of fish communities. The environmental data set, analysed alone through between-within group 'principal component analysis' (PCA), exhibited a significant spatial and temporal variability. The fish data set, however, presented only a significant spatial structure, stable over the year. Given the lack of temporal variability in fish distribution, a 'between-site co-structure analysis' (BSCA) was used to compare the faunistic and environmental structures in space. The co-inertia structure was reduced to one axis representing a strong coast-reef gradient, the major common phenomena to both data sets. Environment and fish distribution allowed to distinguish sites directly under mangrove influence (characterised by high seagrasses, high concentration of chlorophyll a and high densities of zooplankton), to sites under reef influence (with short but dense seagrasses, clear water, and poor nutriments). For that purposes, the BSCA summarised efficiently what in common the fauna spatial structure and the environment spatial structure may present.