No abstract

A useful technique for skin repair in medium-sized lumbar or lumbosacral myelomeningoceles is described. It consists in the displacement towards the midline of two lateral triangular flaps located on each side of the lesion. This technique has been used to cover skin defects in other regions of the body, but not in the lumbar region for myelomeningoceles. The results are encouraging.

A brief summary is presented of the epidemiological, embryological, clinical, and etiological aspects of myelomeningocele. The natural history of this disease is reviewed, as are the implications of present-day treatment. An analysis is made of the cost of overall treatment, including neurological, orthopedic and urological surgery, as well as physical and psychological rehabilitation and specialized educational therapy. The costs are high, both monetarily and from the viewpoint of social handicaps. The author's personal experience is analyzed. The outcome of treatment is poor, probably due to the economic limits which do not allow full treatment. Several questions are asked: Should these children be operated upon? Which children should be operated upon? Who must bear the costs of treatment? The author gives his point of view concerning these questions.

This work reports on the fabrication of a novel two-layer material composed of a porous tantalum core and a dense Ti6Al4V (Ti64) shell by powder metallurgy. The porous core was obtained by mixing Ta particles and salt space-holders to create large pores, the green compact was obtained by pressing. The sintering behavior of the two-layer sample was studied by dilatometry. The interface bonding between the Ti64 and Ta layers was analyzed by SEM, and the pore characteristics were analyzed by computed microtomography. Images showed that two distinct layers were obtained with a bonding achieved by the solid-state diffusion of Ta particles into Ti64 during sintering. The formation of β-Ti and α′ martensitic phases confirmed the diffusion of Ta. The pore size distribution was in the size range of 80 to 500 µm, and a permeability value of 6 × 10−10 m2 was close to the trabecular bones one. The mechanical properties of the component were dominated mainly by the porous layer, and Young’s modulus of 16 GPa was in the range of bones. Additionally, the density of this material (6 g/cm3) was much lower than the one of pure Ta, which helps to reduce the weight for the desired applications. These results indicate that structurally hybridized materials, also known as composites, with specific property profiles can improve the response to osseointegration for bone implant applications.