[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"disease-index":3,"disease-15":121,"navigation-categories":615,"navigation-categories-fr":734},{"data":4,"meta":117},[5,11,17,23,28,34,40,46,52,58,64,70,76,82,88,94,100,106,111],{"id":6,"attributes":7},4,{"title":8,"title_en":9,"slug_en":10},"Hernie discale lombaire","Lumbar Disc Herniation","lumbar-disc-herniation",{"id":12,"attributes":13},5,{"title":14,"title_en":15,"slug_en":16},"Prothèse totale de hanche ","Total Hip Replacement","total-hip-replacement",{"id":18,"attributes":19},7,{"title":20,"title_en":21,"slug_en":22},"ménisque","Meniscus","meniscus",{"id":24,"attributes":25},8,{"title":26,"title_en":26,"slug_en":27},"Hallux Valgus","hallux-valgus",{"id":29,"attributes":30},16,{"title":31,"title_en":32,"slug_en":33},"Pathologie dégénérative cheville","Degenerative Ankle Disease","degenerative-ankle-disease",{"id":35,"attributes":36},20,{"title":37,"title_en":38,"slug_en":39},"Prothèse épaule","Shoulder Replacement","shoulder-replacement",{"id":41,"attributes":42},19,{"title":43,"title_en":44,"slug_en":45},"Pathologies de la coiffe des rotateurs ","Rotator Cuff Disorders","rotator-cuff-disorders",{"id":47,"attributes":48},18,{"title":49,"title_en":50,"slug_en":51},"Rupture du tendon d'Achille","Achilles Tendon Rupture","achilles-tendon-rupture",{"id":53,"attributes":54},9,{"title":55,"title_en":56,"slug_en":57},"Le névrome de Morton ","Morton's neuroma","morton-s-neuroma",{"id":59,"attributes":60},22,{"title":61,"title_en":62,"slug_en":63},"L’instabilité d’épaule","Shoulder Instability","shoulder-instability",{"id":65,"attributes":66},23,{"title":67,"title_en":68,"slug_en":69},"Capsulite rétractile","Adhesive Capsulitis (Frozen Shoulder)","adhesive-capsulitis-frozen-shoulder",{"id":71,"attributes":72},11,{"title":73,"title_en":74,"slug_en":75},"La Pathologie Ligamentaire","Ligament Pathology","ligament-pathology",{"id":77,"attributes":78},17,{"title":79,"title_en":80,"slug_en":81},"La prothèse totale de genou ","Total Knee Replacement","total-knee-replacement",{"id":83,"attributes":84},24,{"title":85,"title_en":86,"slug_en":87},"Principes de rééducations ","Principles of rehabilitation","principles-of-rehabilitation",{"id":89,"attributes":90},14,{"title":91,"title_en":92,"slug_en":93},"Pathologie de la Rotule","Patellar Disorders","patellar-disorders",{"id":95,"attributes":96},21,{"title":97,"title_en":98,"slug_en":99},"Fracture épaule","Shoulder Fracture","shoulder-fracture",{"id":101,"attributes":102},15,{"title":103,"title_en":104,"slug_en":105},"Pathologie ligamentaire cheville","Ankle Ligament Pathology","ankle-ligament-pathology",{"id":107,"attributes":108},6,{"title":109,"title_en":110,"slug_en":110},"coxarthrose ","coxarthrosis",{"id":112,"attributes":113},10,{"title":114,"title_en":115,"slug_en":116},"Griffes d’orteils et métatarsalgies ","Toe claws and metatarsalgia","toe-claws-and-metatarsalgia",{"pagination":118},{"page":119,"pageSize":120,"pageCount":119,"total":41},1,100,{"data":122,"meta":614},{"id":101,"attributes":123},{"title":103,"content":124,"createdAt":392,"updatedAt":393,"publishedAt":394,"summary":191,"seoTitle":191,"seoDescription":191,"author":191,"reviewedBy":191,"medicalReviewer":191,"medicalReviewedAt":191,"associatedAnatomy":191,"title_en":104,"slug_en":105,"summary_en":191,"seoTitle_en":191,"seoDescription_en":191,"content_en":395,"associatedAnatomy_en":191,"ogImage":602,"pathologie_par_articulation":603,"sources":609,"relatedSurgeries":610,"possibleTreatments":612,"signsOrSymptoms":613},[125,131,137,140,144,148,151,155,158,162,165,169,173,176,180,205,208,211,215,219,223,227,231,235,239,242,245,248,252,256,259,263,267,271,274,293,296,300,304,307,325,328,332,336,340,344,347,350,354,358,362,366,370,374],{"type":126,"children":127},"paragraph",[128],{"text":129,"type":130},"","text",{"type":132,"level":133,"children":134},"heading",2,[135],{"text":136,"type":130},"Entorse cheville",{"type":126,"children":138},[139],{"text":129,"type":130},{"type":126,"children":141},[142],{"text":143,"type":130},"l s’agit de la pathologie traumatique la plus fréquente. Elle concerne une personne sur 10 000 par jour. Elle représente jusqu’à 50 % des accidents chez le footballeur.",{"type":126,"children":145},[146],{"text":147,"type":130},"9 fois sur dix, elle concerne le ligament latéral externe de la cheville.",{"type":126,"children":149},[150],{"text":129,"type":130},{"type":132,"level":6,"children":152},[153],{"text":154,"type":130},"ENTORSE RECENTE",{"type":126,"children":156},[157],{"text":129,"type":130},{"type":126,"children":159},[160],{"text":161,"type":130},"Habituellement, le patient se “ tord ” la cheville . le pied partant en dedans.",{"type":126,"children":163},[164],{"text":129,"type":130},{"type":126,"children":166},[167],{"text":168,"type":130},"La douleur initiale est aiguë. On peut entendre un craquement. Néanmoins, dans le feu de l’action, le patient poursuit souvent son activité sportive.",{"type":126,"children":170},[171],{"text":172,"type":130},"La douleur réapparaît régulièrement quelques heures plus tard et s’intensifie.La cheville gonfle et l’on constate quelques fois le fameux “ œuf de pigeon ” qui est en fait une poche de sang sur le bord latéral de la cheville.",{"type":126,"children":174},[175],{"text":129,"type":130},{"type":126,"children":177},[178],{"text":179,"type":130},"La lésion est variable. Il peut s’agir d’un simple “ étirement ” tendineux, d’une déchirure partielle ou d’un arrachement complet du ligament latéral externe. Le plus souvent, c’est le faisceau antérieur du ligament qui est lésé.",{"type":181,"image":182,"children":203},"image",{"ext":183,"url":184,"hash":185,"mime":186,"name":187,"size":188,"width":189,"height":190,"caption":191,"formats":192,"provider":201,"createdAt":202,"updatedAt":202,"previewUrl":191,"alternativeText":187,"provider_metadata":191},".jpg","https:\u002F\u002Flircos.org\u002Fapi\u002Fuploads\u002Fcheville_1_ade4939c56.jpg","cheville_1_ade4939c56","image\u002Fjpeg","cheville 1.jpg",13.24,400,279,null,{"thumbnail":193},{"ext":183,"url":194,"hash":195,"mime":186,"name":196,"path":191,"size":197,"width":198,"height":199,"sizeInBytes":200},"\u002Fuploads\u002Fthumbnail_cheville_1_ade4939c56.jpg","thumbnail_cheville_1_ade4939c56","thumbnail_cheville 1.jpg",6.01,224,156,6005,"local","2024-09-03T14:20:44.751Z",[204],{"text":129,"type":130},{"type":126,"children":206},[207],{"text":129,"type":130},{"type":126,"children":209},[210],{"text":129,"type":130},{"type":126,"children":212},[213],{"text":214,"type":130},"Le traitement initial nécessite de “ glacer ” la cheville afin de limiter son gonflement et donc la douleur. Il faut surélever la cheville. L’appui et les déplacements doivent être limités. La prescription d’antalgiques et d’anti-inflammatoires, l’usage de cannes anglaises sont utiles à la phase initiale.",{"type":126,"children":216},[217],{"text":218,"type":130},"Dès la reprise de l’appui, il faut mettre en place une orthèse souple généralement pour 5 à 6 semaines (durée de la cicatrisation ligamentaire). Ce système comprend 2 valves en plastiques reliées par des Velcros qui empêchent la cheville de se tordre et de recréer le mécanisme lésionnel qui a occasionné l’entorse. Il en existe de très nombreux modèles (Airlock ,aircast , axmed ……) qui remplacent avantageusement les bottes plâtrées , permettent un appui total et ne nécessitent généralement pas la mise sous anticoagulants.",{"type":126,"children":220},[221],{"text":222,"type":130},"Vers le 10e jour, on débutera une rééducation qui devra répondre à plusieurs objectifs :",{"type":126,"children":224},[225],{"text":226,"type":130},"– lutte contre l’œdème et les douleurs, avec massages de drainage et ultrasons",{"type":126,"children":228},[229],{"text":230,"type":130},"– récupération des amplitudes articulaires",{"type":126,"children":232},[233],{"text":234,"type":130},"– rééducation proprioceptive : il s’agit d’apprendre au patient à verrouiller sa cheville, en lui réapprenant à se stabiliser sur des plateaux instables ou des ballons. Ces exercices sont indispensables pour éviter la récidive de l’entorse et l’apparition d’une cheville instable.",{"type":132,"level":133,"children":236},[237],{"text":238,"type":130},"instabilité de cheville",{"type":126,"children":240},[241],{"text":129,"type":130},{"type":126,"children":243},[244],{"text":129,"type":130},{"type":126,"children":246},[247],{"text":129,"type":130},{"type":126,"children":249},[250],{"text":251,"type":130},"Il s’agit de la récidive d’entorses de la cheville régulières et sans raisons déclenchantes apparentes . Le patient se “ tord ” la cheville facilement. Il existe plusieurs épisodes par ans et la pratique sportive est fréquemment interrompue.",{"type":126,"children":253},[254],{"text":255,"type":130},"Parfois , c’est la persistance de douleurs de chevilles qui conduisent au diagnostic.",{"type":126,"children":257},[258],{"text":129,"type":130},{"type":126,"children":260},[261],{"text":262,"type":130},"Celui-ci sera confirmé par la réalisation de clichés dynamiques qui nécessitent de tordre la cheville et permettent de confirmer le bâillement excessif de l’articulation entre le tibia et le talus.",{"type":126,"children":264},[265],{"text":266,"type":130},"On effectue également des manœuvres de tiroir antérieur ou la cheville est poussée en avant par rapport à la jambe.",{"type":126,"children":268},[269],{"text":270,"type":130},"Les radiographies sont effectuées de façon comparative.",{"type":126,"children":272},[273],{"text":129,"type":130},{"type":181,"image":275,"children":291},{"ext":183,"url":276,"hash":277,"mime":186,"name":278,"size":279,"width":189,"height":280,"caption":191,"formats":281,"provider":201,"createdAt":290,"updatedAt":290,"previewUrl":191,"alternativeText":278,"provider_metadata":191},"https:\u002F\u002Flircos.org\u002Fapi\u002Fuploads\u002Fcheville_2_0902b239b4.jpg","cheville_2_0902b239b4","cheville 2.jpg",12.93,201,{"thumbnail":282},{"ext":183,"url":283,"hash":284,"mime":186,"name":285,"path":191,"size":286,"width":287,"height":288,"sizeInBytes":289},"\u002Fuploads\u002Fthumbnail_cheville_2_0902b239b4.jpg","thumbnail_cheville_2_0902b239b4","thumbnail_cheville 2.jpg",6.38,245,123,6377,"2024-09-03T14:20:44.746Z",[292],{"text":129,"type":130},{"type":126,"children":294},[295],{"text":129,"type":130},{"type":126,"children":297},[298],{"text":299,"type":130},"En absence d’amélioration suffisante par une kinésithérapie proprioceptive bien menée, il est nécessaire de “ reconstruire ” un plan externe.",{"type":126,"children":301},[302],{"text":303,"type":130},"Le plus souvent on effectue une remise en tension du plan externe qui a cicatrisé de façon trop lâche. Selon la qualité du reliquat tendineux, on associe parfois un renfort avec le tissu tapissant le péroné. On parle alors d’un lambeau au périoste.",{"type":126,"children":305},[306],{"text":129,"type":130},{"type":181,"image":308,"children":323},{"ext":183,"url":309,"hash":310,"mime":186,"name":311,"size":312,"width":189,"height":313,"caption":191,"formats":314,"provider":201,"createdAt":322,"updatedAt":322,"previewUrl":191,"alternativeText":311,"provider_metadata":191},"https:\u002F\u002Flircos.org\u002Fapi\u002Fuploads\u002Fcheville_3_ccff994549.jpg","cheville_3_ccff994549","cheville 3.jpg",11.75,292,{"thumbnail":315},{"ext":183,"url":316,"hash":317,"mime":186,"name":318,"path":191,"size":319,"width":320,"height":199,"sizeInBytes":321},"\u002Fuploads\u002Fthumbnail_cheville_3_ccff994549.jpg","thumbnail_cheville_3_ccff994549","thumbnail_cheville 3.jpg",4.9,214,4903,"2024-09-03T14:20:44.780Z",[324],{"text":129,"type":130},{"type":126,"children":326},[327],{"text":129,"type":130},{"type":126,"children":329},[330],{"text":331,"type":130},"En pratique, l’hospitalisation est ambulatoire",{"type":126,"children":333},[334],{"text":335,"type":130},"Le patient est immobilisé par une botte durant 21 jours sans appui. Secondairement l’appui est autorisé et l’on débute une rééducation. L’immobilisation est limitée au port d’une orthèse amovible pour encore 3 semaines.",{"type":126,"children":337},[338],{"text":339,"type":130},"L’arrêt de travail est d’un mois pour un sédentaire et de 2 mois pour un travailleur de force.",{"type":126,"children":341},[342],{"text":343,"type":130},"Conflit antérieur de cheville",{"type":126,"children":345},[346],{"text":129,"type":130},{"type":126,"children":348},[349],{"text":129,"type":130},{"type":126,"children":351},[352],{"text":353,"type":130},"Le patient se plaint essentiellement d’une douleur sur le bord antéro externe de la cheville. Cette gêne prédomine en position accroupie et en flexion dorsale de la cheville. Celle-ci est souvent empatée et gonfle parfois.",{"type":126,"children":355},[356],{"text":357,"type":130},"Il peut exister une sensation subjective d’instabilité de la cheville. Néanmoins, les clichés dynamiques ne retrouvent pas d’instabilité objective. Il s’agit de la conséquence d’entorses à répétitions.",{"type":126,"children":359},[360],{"text":361,"type":130},"Un tissu de cicatrisation apparaît après chaque entorse du LLE. Ce tissu volumineux peut encombrer l’articulation et se coincer dans l’articulation lors de certains mouvements.",{"type":126,"children":363},[364],{"text":365,"type":130},"Il s’agit d’un diagnostic d’élimination après la réalisation d’un arthroscanner éliminant une autre cause. On peut mettre en évidence par cet examen ce tissu cicatriciel hypertrophique.",{"type":126,"children":367},[368],{"text":369,"type":130},"Une infiltration d’anesthésique local est réalisée durant l’examen et soulage le patient.",{"type":126,"children":371},[372],{"text":373,"type":130},"Le traitement consiste en une résection du tissu cicatriciel sous arthroscopie. Ce geste a lieu sous anesthésie loco régionale.",{"type":181,"image":375,"children":390},{"ext":183,"url":376,"hash":377,"mime":186,"name":378,"size":379,"width":189,"height":380,"caption":191,"formats":381,"provider":201,"createdAt":389,"updatedAt":389,"previewUrl":191,"alternativeText":378,"provider_metadata":191},"https:\u002F\u002Flircos.org\u002Fapi\u002Fuploads\u002Fcheville_4_fd67964f61.jpg","cheville_4_fd67964f61","cheville 4.jpg",14.66,308,{"thumbnail":382},{"ext":183,"url":383,"hash":384,"mime":186,"name":385,"path":191,"size":386,"width":387,"height":199,"sizeInBytes":388},"\u002Fuploads\u002Fthumbnail_cheville_4_fd67964f61.jpg","thumbnail_cheville_4_fd67964f61","thumbnail_cheville 4.jpg",5.52,203,5521,"2024-09-03T14:20:44.795Z",[391],{"text":129,"type":130},"2024-09-03T14:22:43.525Z","2024-10-19T13:47:30.417Z","2024-09-03T14:22:45.292Z",[396,399,403,406,410,414,417,421,424,428,431,435,439,442,446,452,455,458,462,466,470,474,478,482,486,489,492,495,499,503,506,510,514,518,521,527,530,534,538,541,547,550,554,558,562,566,569,572,576,580,584,588,592,596],{"type":126,"children":397},[398],{"text":129,"type":130},{"type":132,"level":133,"children":400},[401],{"text":402,"type":130},"Sprained ankle",{"type":126,"children":404},[405],{"text":129,"type":130},{"type":126,"children":407},[408],{"text":409,"type":130},"This is the most common traumatic pathology. It affects one in 10,000 people per day. It represents up to 50% of accidents among footballers.",{"type":126,"children":411},[412],{"text":413,"type":130},"9 times out of ten, it concerns the external lateral ligament of the ankle.",{"type":126,"children":415},[416],{"text":129,"type":130},{"type":132,"level":6,"children":418},[419],{"text":420,"type":130},"RECENT SPRAIN",{"type":126,"children":422},[423],{"text":129,"type":130},{"type":126,"children":425},[426],{"text":427,"type":130},"Usually, the patient “twists” the ankle. the foot going inwards.",{"type":126,"children":429},[430],{"text":129,"type":130},{"type":126,"children":432},[433],{"text":434,"type":130},"The initial pain is acute. You can hear a crack. However, in the heat of the moment, the patient often continues his sporting activity.",{"type":126,"children":436},[437],{"text":438,"type":130},"The pain reappears regularly a few hours later and intensifies. The ankle swells and we sometimes notice the famous “pigeon egg” which is in fact a pocket of blood on the lateral edge of the ankle.",{"type":126,"children":440},[441],{"text":129,"type":130},{"type":126,"children":443},[444],{"text":445,"type":130},"The lesion is variable. It may be a simple tendon “stretch”, a partial tear or a complete tearing of the external lateral ligament. Most often, it is the anterior bundle of the ligament that is injured.",{"type":181,"image":447,"children":450},{"ext":183,"url":184,"hash":185,"mime":186,"name":187,"size":188,"width":189,"height":190,"caption":191,"formats":448,"provider":201,"createdAt":202,"updatedAt":202,"previewUrl":191,"alternativeText":187,"provider_metadata":191},{"thumbnail":449},{"ext":183,"url":194,"hash":195,"mime":186,"name":196,"path":191,"size":197,"width":198,"height":199,"sizeInBytes":200},[451],{"text":129,"type":130},{"type":126,"children":453},[454],{"text":129,"type":130},{"type":126,"children":456},[457],{"text":129,"type":130},{"type":126,"children":459},[460],{"text":461,"type":130},"Initial treatment requires “icing” the ankle in order to limit swelling and therefore pain. The ankle must be elevated. Support and movement should be limited. The prescription of analgesics and anti-inflammatories and the use of canes are useful in the initial phase.",{"type":126,"children":463},[464],{"text":465,"type":130},"As soon as support resumes, a flexible orthosis must be put in place, generally for 5 to 6 weeks (duration of ligament healing). This system includes 2 plastic valves connected by Velcro which prevent the ankle from twisting and recreating the injury mechanism which caused the sprain. There are many models (Airlock, aircast, axmed, etc.) which advantageously replace plaster boots, allow total support and generally do not require anticoagulants.",{"type":126,"children":467},[468],{"text":469,"type":130},"Around the 10th day, we will begin rehabilitation which must meet several objectives:",{"type":126,"children":471},[472],{"text":473,"type":130},"– fight against edema and pain, with drainage massages and ultrasound",{"type":126,"children":475},[476],{"text":477,"type":130},"– recovery of joint range of motion",{"type":126,"children":479},[480],{"text":481,"type":130},"– proprioceptive rehabilitation: this involves teaching the patient to lock their ankle, by re-teaching them to stabilize themselves on unstable platforms or balls. These exercises are essential to avoid the recurrence of the sprain and the appearance of an unstable ankle.",{"type":132,"level":133,"children":483},[484],{"text":485,"type":130},"ankle instability",{"type":126,"children":487},[488],{"text":129,"type":130},{"type":126,"children":490},[491],{"text":129,"type":130},{"type":126,"children":493},[494],{"text":129,"type":130},{"type":126,"children":496},[497],{"text":498,"type":130},"This is the recurrence of regular ankle sprains without apparent triggering reasons. The patient “twists” the ankle easily. There are several episodes per year and sports practice is frequently interrupted.",{"type":126,"children":500},[501],{"text":502,"type":130},"Sometimes, it is the persistence of ankle pain that leads to the diagnosis.",{"type":126,"children":504},[505],{"text":129,"type":130},{"type":126,"children":507},[508],{"text":509,"type":130},"This will be confirmed by taking dynamic images which require twisting the ankle and confirm excessive yawning of the joint between the tibia and the talus.",{"type":126,"children":511},[512],{"text":513,"type":130},"Anterior drawer maneuvers are also performed where the ankle is pushed forward in relation to the leg.",{"type":126,"children":515},[516],{"text":517,"type":130},"The x-rays are taken in a comparative manner.",{"type":126,"children":519},[520],{"text":129,"type":130},{"type":181,"image":522,"children":525},{"ext":183,"url":276,"hash":277,"mime":186,"name":278,"size":279,"width":189,"height":280,"caption":191,"formats":523,"provider":201,"createdAt":290,"updatedAt":290,"previewUrl":191,"alternativeText":278,"provider_metadata":191},{"thumbnail":524},{"ext":183,"url":283,"hash":284,"mime":186,"name":285,"path":191,"size":286,"width":287,"height":288,"sizeInBytes":289},[526],{"text":129,"type":130},{"type":126,"children":528},[529],{"text":129,"type":130},{"type":126,"children":531},[532],{"text":533,"type":130},"In the absence of sufficient improvement through well-conducted proprioceptive physiotherapy, it is necessary to “reconstruct” an external plan.",{"type":126,"children":535},[536],{"text":537,"type":130},"Most often we carry out a re-tensioning of the external plane which has healed too loosely. Depending on the quality of the remaining tendon, reinforcement is sometimes combined with the tissue lining the fibula. We then speak of a periosteal flap.",{"type":126,"children":539},[540],{"text":129,"type":130},{"type":181,"image":542,"children":545},{"ext":183,"url":309,"hash":310,"mime":186,"name":311,"size":312,"width":189,"height":313,"caption":191,"formats":543,"provider":201,"createdAt":322,"updatedAt":322,"previewUrl":191,"alternativeText":311,"provider_metadata":191},{"thumbnail":544},{"ext":183,"url":316,"hash":317,"mime":186,"name":318,"path":191,"size":319,"width":320,"height":199,"sizeInBytes":321},[546],{"text":129,"type":130},{"type":126,"children":548},[549],{"text":129,"type":130},{"type":126,"children":551},[552],{"text":553,"type":130},"In practice, hospitalization is outpatient",{"type":126,"children":555},[556],{"text":557,"type":130},"The patient is immobilized by a boot for 21 days without support. Secondarily, support is authorized and rehabilitation begins. Immobilization is limited to wearing a removable orthosis for another 3 weeks.",{"type":126,"children":559},[560],{"text":561,"type":130},"The work stoppage is one month for a sedentary worker and 2 months for a forced worker.",{"type":126,"children":563},[564],{"text":565,"type":130},"Anterior ankle impingement",{"type":126,"children":567},[568],{"text":129,"type":130},{"type":126,"children":570},[571],{"text":129,"type":130},{"type":126,"children":573},[574],{"text":575,"type":130},"The patient mainly complains of pain on the anterolateral edge of the ankle. This discomfort predominates in a squatting position and dorsiflexion of the ankle. This is often thick and sometimes swells.",{"type":126,"children":577},[578],{"text":579,"type":130},"There may be a subjective feeling of ankle instability. However, dynamic images do not find objective instability. This is the consequence of repeated sprains.",{"type":126,"children":581},[582],{"text":583,"type":130},"Healing tissue appears after each LLE sprain. This bulky tissue can crowd the joint and get stuck in the joint during certain movements.",{"type":126,"children":585},[586],{"text":587,"type":130},"This is a diagnosis of elimination after carrying out a CT arthrography eliminating another cause. This examination can highlight this hypertrophic scar tissue.",{"type":126,"children":589},[590],{"text":591,"type":130},"A local anesthetic infiltration is carried out during the examination and relieves the patient.",{"type":126,"children":593},[594],{"text":595,"type":130},"Treatment consists of arthroscopic resection of the scar tissue. 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