{"id":2590,"date":"2025-02-08T21:10:51","date_gmt":"2025-02-08T20:10:51","guid":{"rendered":"https:\/\/kineaphp.fr\/?p=2590"},"modified":"2025-02-16T10:04:14","modified_gmt":"2025-02-16T09:04:14","slug":"fracture-de-stress-tibiale","status":"publish","type":"post","link":"https:\/\/kineaphp.fr\/?p=2590","title":{"rendered":"Fracture de stress tibiale"},"content":{"rendered":"\n<p><\/p>\n\n\n\n<div class=\"wp-block-media-text has-media-on-the-right is-stacked-on-mobile\" style=\"grid-template-columns:auto 27%\"><div class=\"wp-block-media-text__content\">\n<p><strong>D\u00e9finition<\/strong><br>L\u00e9sion osseuse due \u00e0 une sollicitation r\u00e9p\u00e9t\u00e9e et excessive, g\u00e9n\u00e9ralement sur une longue p\u00e9riode. Elle se produit lorsque les contraintes m\u00e9caniques (pression, traction, cisaillement) sont sup\u00e9rieures \u00e0 la r\u00e9sistance de l\u2019os.\u00a0<\/p>\n\n\n\n<p><strong>Epid\u00e9miologie<\/strong><br>Elles constituent 1\/4 des fractures de stress (les plus fr\u00e9quentes). La pr\u00e9valence est \u00e9lev\u00e9e chez les pratiquants de sports \u00e0 fort impact, les militaires et les coureurs de fond.<\/p>\n\n\n\n<p>Facteurs de risque<\/p>\n<\/div><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-47-png.avif\" alt=\"\" class=\"wp-image-2999 size-full\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-47-png.avif 1024w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-47-300x300.avif 300w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-47-150x150.avif 150w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-47-768x768.avif 768w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-47-144x144.avif 144w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-47-80x80.avif 80w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure><\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<div class=\"wp-block-media-text has-media-on-the-right is-stacked-on-mobile\"><div class=\"wp-block-media-text__content\">\n<p><strong>Physiopathologie<\/strong><br>Les contraintes m\u00e9caniques r\u00e9p\u00e9t\u00e9es d\u00e9passent les capacit\u00e9s de r\u00e9paration de l&rsquo;os. Cela engendre une perturbation du sch\u00e9ma de remodelage osseux entra\u00eenant des microfissures pouvant aller jusqu&rsquo;\u00e0 la fracture.<\/p>\n\n\n\n<p><strong>Incidence de la localisation de la fracture<\/strong><br>&#8211; Post\u00e9ro-m\u00e9diale : risque faible et plus rapide \u00e0 gu\u00e9rir<br>&#8211; Ant\u00e9rieur : haut risque mais plus rare et moins rapide \u00e0 gu\u00e9rir (r\u00e9sistance au traitement non chirurgical)<\/p>\n\n\n\n<p><strong>Prototype clinique<\/strong><br>&#8211; Douleur le long du tibia, ressemblant \u00e0 une p\u00e9riostite mais plus pr\u00e9cise et localis\u00e9e<br>&#8211; Exacerb\u00e9e par l&rsquo;activit\u00e9 physique avec impact entra\u00eenant l&rsquo;arr\u00eat de l&rsquo;activit\u00e9<br>&#8211; Soulag\u00e9e par le repos<\/p>\n<\/div><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"817\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-48-1024x817.avif\" alt=\"\" class=\"wp-image-3002 size-full\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-48-1024x817.avif 1024w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-48-300x239.avif 300w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-48-768x613.avif 768w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-48-1536x1225.avif 1536w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-48-2048x1634.avif 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure><\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<div class=\"wp-block-media-text is-stacked-on-mobile\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"218\" height=\"128\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-50-png.avif\" alt=\"\" class=\"wp-image-3006 size-full\"\/><\/figure><div class=\"wp-block-media-text__content\">\n<p><strong>Diagnostic<\/strong><br>&#8211; Palpation : sensibilit\u00e9 sur une zone inf\u00e9rieure \u00e0 10 cm (souvent 5cm)<br>&#8211; Test du saut sur une jambe provoque une douleur dans le tibia<br>&#8211; Test de Fulcrum : pression sur le tibia (sensibilit\u00e9 faible)<\/p>\n<\/div><\/div>\n\n\n\n<p><strong>Examen paraclinique<\/strong><br>&#8211; IRM : outil de r\u00e9f\u00e9rence permettant de visualiser un oed\u00e8me osseux ou une micro-fracture (non visible \u00e0 la radio)<br>&#8211; Scintigraphie osseuse (moins sp\u00e9cifique)<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Th\u00e9rapeutique<\/strong><br><strong>1\u00e8re intention : conservateur<\/strong><br>&#8211; Repos et adaptation de l&rsquo;entra\u00eenement<br>&#8211; Activit\u00e9s physique \u00e0 faible impact : natation, v\u00e9lo pour maintenir la condition physique<\/p>\n\n\n\n<p><strong>2\u00e8me intention : r\u00e9\u00e9ducation active<\/strong><br>&#8211; Renforcement<br>&#8211; Correction des anomalies biom\u00e9caniques<br>&#8211; Introduction progressives d&rsquo;impacts<\/p>\n\n\n\n<p><strong>3\u00e8me intention : chirurgie pour fracture ant\u00e9rieure notamment<\/strong><br>&#8211; Clou intram\u00e9dullaire, plaque de compression ou forage osseux<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Pr\u00e9vention<\/strong><br>&#8211; <strong>Education <\/strong>: temps de r\u00e9cup\u00e9ration entre les s\u00e9ances (repos ad\u00e9quat)<br>&#8211; <strong>Gestion de l&rsquo;entrainement<\/strong> : augmentation progressive de la charge d&rsquo;entra\u00eenement (gestion de stress m\u00e9canique)<br>&#8211; <strong>Renforcement musculaire<\/strong> des muscles stabilisateurs de la jambe et du pied permettant de diminuer la surcharge tibiale.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Vid\u00e9os<\/strong><br><em>Renforcement des muscles du pied<\/em> par PhysioAcad\u00e9mie<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"TP - Renforcement des muscles du Pied\" width=\"925\" height=\"520\" src=\"https:\/\/www.youtube.com\/embed\/HS-v2trAj5M?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p><em>Exercices de renforcement musculaire course \u00e0 pied : 10&prime; par jour suffisent [Exercices + \u00e9volutions] <\/em>par Running Addict<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Exercices de renforcement musculaire course \u00e0 pied : 10&#039; par jour suffisent [Exercices + \u00e9volutions]\" width=\"925\" height=\"520\" src=\"https:\/\/www.youtube.com\/embed\/jSO1-3Obt7Y?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>D\u00e9finitionL\u00e9sion osseuse due \u00e0 une sollicitation r\u00e9p\u00e9t\u00e9e et excessive, g\u00e9n\u00e9ralement sur une longue p\u00e9riode. Elle se produit lorsque les contraintes m\u00e9caniques (pression, traction, cisaillement) sont sup\u00e9rieures \u00e0 la r\u00e9sistance de l\u2019os.\u00a0 Epid\u00e9miologieElles constituent 1\/4 des&hellip;<\/p>\n<p class=\"more-link-wrapper\"><a href=\"https:\/\/kineaphp.fr\/?p=2590\" class=\"more-link\">Continue Reading<span class=\"screen-reader-text\"> \u00ab\u00a0Fracture de stress tibiale\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-2590","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\/2590","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=2590"}],"version-history":[{"count":9,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/2590\/revisions"}],"predecessor-version":[{"id":3027,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/2590\/revisions\/3027"}],"wp:attachment":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2590"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2590"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2590"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}