fractures du scaphoide traitement place de l'arthroscopie

7/26/2019 Fractures Du Scaphoide Traitement Place de l'Arthroscopie

1/35

Arj`turbs mu s`jpoimb]rjgtbhbet, pcj`b mb cjrtorisìpgb

DH @ifebt

PIP Hjges @ojhpjfeb Jrmbeeb

îcy`cgegqub Pjget Jemr, 2 Liucbvjrm mb cj pjgx2::>> \BGHP, Arje`b ottp4//www.hjgebtpigfebt.ìh

MR @ogrurfgb mb cj Hjge :> djevgbr :2


2/35

Arj`turb arqubetb

% mbs arj`turbs mbs is mu `jrpb. tiuòb coihhb dbueb (mb :2 =2 jes)

H`jegshb @outb sur cj pjuhb mb cj hjge pigfebt be oypbrbxtbesgie

\gsqub hìeejgssje`b mgjfeistgqub arqube`b mbs ìhpcg`jtgies ghpirtje`b mb cj prgsb be òjrfb gegtgjcb rbtbetgssbhbet si`gi-ìeihgqub

Bpgmhgicifgb

1:,< %

=,0 %0,: %2,= %

6,> %:0,1 %:,= %

=,> %


3/35

Zubccb vjsùcjrgsjtgie piur cb s`jpoimb 9

Fbclbrhje \O, Hbeie D. ]obvjsùcjrgty ia tob s`jpoigmlieb. D Ojem Purf Jh. :7?>, 242>?:0.

Mirsjc vgbw ia tob s`jpoigm ia tob rgfot ojem. ]ob mirsjc s`jpoigmjrtbry (:) irgfgejtbs arih tob rjmgjc jrtbry (\) jem sbems twi soirtlrjeòbs ti tob mirsjc rjmgjc suraj`b ia tob s`jpoigm (7 Due;0=(0)402:-6.


4/35

^sbumjrtoisbs (:>-2>%)

E`risbs prixghjcbs

@jcs vg`gbux

Msjxjtgies `jrpgbeebs

Jrtorisb rjmgi bt hbmgi-`jrpgbeeb (PEJ@ Vrgst)

@ihpcg`jtgies pitbetgbccbs


5/35

Jttgtumb torjpbutgqub

@oigx betrb trjgtbhbet irtoipmgqub iu ògrurfg`jc

Qj mpbemrb mb mgaarbets `rgtrbs

typb mb arj`turb

priagc mu pjtgbethjtrgbc mgspieglcbbxprgbe`b mu ògrurfgbe

@cjssgag`jtgie mb Pòbrelbrf


6/35

@cjssgag`jtgie mbs arj`turbs mu s`jpoimb

@cjssgag`jtgie mb P`obrelbrf

@cjssgag`jtgie mb Obrlbrt

@jrj`trb prmg`tga sur cvicutgie


7/35

Arj`turbs mu s`jpoimb `jrpgbe@IE@B^] A\ZRBE] (HJGP B\\IE!)

]rjgtbhbet irtoipmgqub 4 Pghpcb Pr

Agjlcb

]rjgtbhbet `ogrurfg`jc 4

mgaag`gcb

rgsqu

\jrbhbet dustgag


8/35

Arj`turbs rbcbvjet mu trjgtbhbetirtoipmgqub

Arj`turb geìhpctb

Arj`turb mu tulbrùcb

]ypb mghhilgcgsjtgie ìetrivbrs

Hjeòbttb sghpcb < 0 higs

@iumb cglrb

@icieeb mu piu`b cglrb

@cjssgag`jtgie mb Obrlbrt


9/35

Jprs trigs higs mghhilgcgsjtgie

Arj`turb gegtgjcbhbeteie mpcj`b


10/35

]DO

]rjgtbhbet irtoipmgqub...


11/35

Arj`turbs rbcbvjet mu ]rjgtbhbet`ogrurfg`jc

Gemg`jtgies airhbccbs.

Arj`turbs mpcj`bs

Arj`turbs gestjlcbs

Arj`turb mu pcb prixghjc

Jssi`gjtgie csgieebccbs.


12/35

^\GE@G^BP

^jrajgtb rmu`tgie mb cj arj`turb

Hjgtrgsb mb cj tbòegqub pjr cb ògrurfgbe4ìurlb mjpprbetgssjfb e`bssjgrb

Beìhlrbhbet hgeghuh mu hjtrgbc

Hilgcgsjtgie prì`b


13/35

Zubc trjgtbhbet ògrurfg`jc 9

vgs 5 lriòbs

vgs `jeucbs 5 vgs eie `jeucbs

vgssjfb pbrùtje 5 ògrurfgb `gbc iuvbrt

ghhilgcgsjtgie ìhpchbetjgrb iptgieebccb

Getrt mb cjrtorisìpgb +++


14/35

Qgssjfb ìhprbssga

Qgs typb Obrlbrt Vogppcb ++

@jeucb, sjes ttb, ìhprbssgie pjr miulcb pjs

Getrimu`tgie mgstjcb iu prixghjcb sbcie cj ci`jcgsjtgie mbcj arj`turb

@gbc iuvbrt sg4 ìhhgeutgie,

mpcj`bhbet pbrsgstjet,

bxprgbe`b mu ògrurfgbe

^brùtje @ietrcb pjr jhpcgag`jtbur mb lrgccje`b

@ietrcb pjr jrtorisìpgb


15/35

Ajut-gc iprbr cbs arj`turbs eie (iu trs pbu )mpcj`bs mu tgbrs hiybe 9

@bs csgies rbprsbetbet cj frjembhjdirgt mbs arj`turbs

@ihhbet òigsgr betrb cb trjgtbhbetirtoipmgqub bt cb trjgtbhbet ògrurfg`jc9

Mbux rfcbs 4 Hjgtrgsbr cbs mbux tbòegqubs bt

eitjhhbet cb trjgtbhbet ògrurfg`jc. Mgsùtbr jvb` cb pjtgbet be cug jyjet mbcgvr

cbs chbets piur qugc pugssb m`gmbr beìeejgssje`b mb `jusb.


16/35

]rjgtbhbet ògrurfg`jc mbs arj`turbs eie mpcj`bs

`jogbr mbs òjrfbs4 Gjtrifeg`gt priòb mb zri

Agjlgcgt mu fbstb

Eb pjs jffrjvbr ueb csgie cgfjhbetjgrbbe pbrhbttjet ueb hilgcgsjtgie prì`b

Qgssjfb pbrùtje sius ìetrcb acuirisìpgqub+

@ietrcb jrtorisìpgqub systhjtgqub


17/35

Istisyetosb pbr`utjeb

pjrfeb cj vjs`ucjrgsjtgie rjmgjcb, cbs cgfts bxtrgesqubs jetrgburs.

@g`jtrg`b vgrtubccb

Cghgtb cberjgmgssbhbet

vgtbr 4

Qgs trip ciefub (rjmgi-`jrpgbeeb/P]])

@ieacgt jvb` ttb fm is B`jrtbhbet mbs arjfhbets

JQJE]JFBP


18/35

Qgssjfb pbr`utje 4 tb`oegqub


19/35

Qgssjfb pbr-`utje

Pugtbs iprjtigrbs 4 jttbccb jhivglcb :2 diurs (piur `brtjges, ju`uebghhilgcgsjtgie), hilgcgsjtgie cglrb mbs migfts bt mu pigfebt.


20/35

Getrt mu ìetrcb jrtorisìpgqub

Qrgag`jtgie mb vgsu mb cj rmu`tgie

\bòbròb bt trjgtbhbet mb csgies jssi`gbs

:> 0>% mb rupturbs mu cgfjhbet s`jpoi-cuejgrb


21/35

Arj`turb eie mpcj`bmu s`jpoimb (typb GG)

Zubc trjgtbhbet 9


22/35


23/35


24/35


25/35

Pugtbs iprjtigrbsPjes csgie s`jpoicuejgrb jssi`gb 4 jttbccb jhivglcb :> diurs

\bprgsb mu trjvjgc :> diurs sg smbetjgrb=2 diurs sg trjvjgccbur hjeubc

spirt mb ojut egvbju 4 pjs jvjet 0 higsJvb` csgie s`jpoicuejgrb 4 lriòjfb P-C bt/iu `jpsucimsb

Agjlgcgsbr cj pri`murbHgeghgsbr cbs ìhpcg`jtgies

Murb titjcb mu fbstb 8 0>heJppriòb fciljcb mu prilchb


26/35

]rjgtbhbet `ogrurfg`jc

Arj`turb cuxjtgie trjes`jpoi-

pbrgcuejgrb stjmb


27/35

Cghgtbs mu trjgtbhbet jrtoris`ipgqubArj`turb mpcj`b +csgie cgfjhbetjgrb (priljlcb!!!).

^jtgbet =0 jes `outbmue pihhgbr..


28/35

Bt mbhjge 9


29/35

Bt mbhjge 9

Judiurmoug9


30/35


31/35


32/35


33/35

>1/>1/:0


34/35

@ie`cusgie

Cb trjgtbhbet ògrurfg`jc mueb arj`turb mu s`jpoimb

`jrpgbe sb migt mtrb pjrajgt

Be `js mb psbumjrtorisb, cvicutgie sb ajgt vbrs

cjrtorisb (PEJ@/PCJ@) be :2 jes Cb ìetrcb jrtorisìpgqub

Qrgagb cj qujcgt mb cj rmu`tgie

\bòbròb cbs csgies jssi`gbs

^brhbt mb frbr cbs sugtbs iprjtigrbs Iuvrb cj pirtb mu trjgtbhbet mbs psbumjrtorisbs

Gc sjfgt mue iutgc gemgspbesjlcb bt qug ìrrbspiem

cilcgfjtgie mb hiybes qug eius bst ghpisb

@ m gt c g !!!


35/35

@b quie eb migt pcus vigr !!!

fractures du scaphoide traitement place de l'arthroscopie

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