{"id":2584,"date":"2025-02-08T21:09:28","date_gmt":"2025-02-08T20:09:28","guid":{"rendered":"https:\/\/kineaphp.fr\/?p=2584"},"modified":"2025-02-14T21:24:19","modified_gmt":"2025-02-14T20:24:19","slug":"entorse-mediale","status":"publish","type":"post","link":"https:\/\/kineaphp.fr\/?p=2584","title":{"rendered":"Entorse m\u00e9diale"},"content":{"rendered":"\n
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D\u00e9finition<\/strong>
Atteinte de l’appareil ligamentaire m\u00e9dial de la cheville.
Epid\u00e9miologie <\/strong>
5% de la population, plus fr\u00e9quente dans la popuation sportive, chez les gymnastes f\u00e9minines notamment.<\/p>\n<\/div>

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Facteurs de risque<\/strong>
Ant\u00e9c\u00e9dent d’entorse de cheville, IMC \u00e9lev\u00e9, sport \u00e0 risque, anatomie du pied (plat, valgus)<\/p>\n\n\n\n

Physiopathologie<\/strong>
Atteinte du ligament delto\u00efde ayant un r\u00f4le dans la limitation de l’\u00e9version subtalaire et de la rotation lat\u00e9rale du pied.
M\u00e9canisme l\u00e9sionnel<\/strong>
Eversion forc\u00e9e de cheville (m\u00eame m\u00e9canisme que syndesmose donc atteinte combin\u00e9e possible).<\/p>\n\n\n\n

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Examen physique<\/strong>
– Palpation du ligament delto\u00efde
– Test de stress pour v\u00e9rifier l’int\u00e9grit\u00e9 du ligament
– Manoeuvre d’\u00e9version forc\u00e9e pour v\u00e9rifier s’il y a une laxit\u00e9<\/p>\n\n\n\n

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Crit\u00e8res d’Ottawa<\/strong>
Si suspicion de fracture, positif si 1 crit\u00e8re sur 4 :<\/p>\n\n\n\n

– Incapacit\u00e9 de marcher sur 4 pas
– Sensibilit\u00e9 osseuse de la partie post de la mall\u00e9ole lat sur 6 cm
– Sensibilit\u00e9 osseuse de la partie post de la mall\u00e9ole m\u00e9d sur 6 cm
– Sensibilit\u00e9 au naviculaire ou base du 5e<\/sup> m\u00e9ta<\/p>\n<\/div><\/div>\n<\/div>\n<\/div>\n\n\n\n

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Crit\u00e8re de Burnese<\/strong> si Ottawa positif
– Compression manuelle tibia-fibula 10 cm au dessus de la mall\u00e9ole
– Compression du talon dans l’axe longitudinal du pied
– Pression directe sur le c\u00f4t\u00e9 m\u00e9dial et lat\u00e9ral de la cheville<\/p>\n<\/div><\/div>\n\n\n\n

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Examens paracliniques<\/strong>
– IRM : examen de r\u00e9f\u00e9rence
– Radio : exclure des fractures associ\u00e9es et \u00e9valuer l’int\u00e9grit\u00e9 structurelle<\/p>\n\n\n\n

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Prototype clinique<\/strong>
– Douleur aig\u00fce en regard du ligament
– Oed\u00e8me
– Ecchymose
– Craquement audible lors du trauma
– Sensation d’instabilit\u00e9 depuis l’entorse<\/p>\n\n\n\n

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Th\u00e9rapeutique<\/strong>
1\u00e8re intention : conservateur si atteinte partielle isol\u00e9e
2\u00e8me intention : chirurgie du LCT (grade 2b et 3) si
– rupture compl\u00e8te
– \u00e9chec traitement conservateur
– atteinte grave du delo\u00efde
– atteinte combin\u00e9e avec d’autres l\u00e9sion (syndesmose, osseuse)<\/p>\n\n\n\n

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Pr\u00e9vention<\/strong>
R\u00e9\u00e9ducation : mise en contrainte progressive du compartiment m\u00e9dial. Travail vers le m\u00e9canisme l\u00e9sionnel en \u00e9version, sans douleur, dans une situation fonctionnelle pour le patient, avec d\u00e9stabilisation intrins\u00e8que ou extrins\u00e8que.<\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

D\u00e9finitionAtteinte de l’appareil ligamentaire m\u00e9dial de la cheville.Epid\u00e9miologie 5% de la population, plus fr\u00e9quente dans la popuation sportive, chez les gymnastes f\u00e9minines notamment. Facteurs de risqueAnt\u00e9c\u00e9dent d’entorse de cheville, IMC \u00e9lev\u00e9, sport \u00e0 risque, anatomie…<\/p>\n

Continue Reading \u00ab\u00a0Entorse m\u00e9diale\u00a0\u00bb<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[358],"tags":[],"class_list":["post-2584","post","type-post","status-publish","format-standard","hentry","category-pathologie-cheville-pied"],"_links":{"self":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/2584","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2584"}],"version-history":[{"count":6,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/2584\/revisions"}],"predecessor-version":[{"id":2956,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/2584\/revisions\/2956"}],"wp:attachment":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2584"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2584"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2584"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}