{"id":2621,"date":"2025-02-08T21:27:43","date_gmt":"2025-02-08T20:27:43","guid":{"rendered":"https:\/\/kineaphp.fr\/?p=2621"},"modified":"2025-02-23T21:50:25","modified_gmt":"2025-02-23T20:50:25","slug":"luxation","status":"publish","type":"post","link":"https:\/\/kineaphp.fr\/?p=2621","title":{"rendered":"Luxation"},"content":{"rendered":"\n<div class=\"wp-block-media-text is-stacked-on-mobile\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"494\" height=\"629\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-102-png.avif\" alt=\"\" class=\"wp-image-3553 size-full\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-102-png.avif 494w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-102-236x300.avif 236w\" sizes=\"auto, (max-width: 494px) 100vw, 494px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p><strong>Facteurs de risque, \u00e9pid\u00e9miologie et physiopathologie<\/strong><\/p>\n\n\n\n<p><strong>Facteur de risque<\/strong><br>&#8211; Laxit\u00e9 ou instabilit\u00e9 ligamentaire pr\u00e9-existante<br>&#8211; Sports \u00e0 chute<br><strong>T\u00eate radiale<\/strong><br>&#8211; Enfant (1 \u00e0 5 ans), 2 \u00e0 5 cas\/1000\/an : par traction axiale brusque en pronation (\u00ab\u00a0coude de la nounou\u00a0\u00bb<br>&#8211; Luxation traumatique de la t\u00eate radiale<\/p>\n\n\n\n<p><strong>T\u00eate hum\u00e9ro-ulnaire<\/strong><br>&#8211; 2\u00e8me luxation la plus pr\u00e9valente apr\u00e8s l&rsquo;\u00e9paule<br>&#8211; 6 cas\/1000\/an<br>&#8211; 30 ans, associ\u00e9e \u00e0 des fractures (AVP, haute intensit\u00e9 pour le jeune, chute pour la personne \u00e2g\u00e9e)<br>&#8211; Chute avec r\u00e9ception sur la main se transmet au coude. La pr\u00e9sence d&rsquo;une laxit\u00e9 provoque la luxation.<\/p>\n<\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Examen physique<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Douleurs intenses<\/li>\n\n\n\n<li>D\u00e9formation visible, perte de continuit\u00e9 des structures<\/li>\n\n\n\n<li>Perte de mobilit\u00e9<\/li>\n\n\n\n<li>Impotence fonctionnelle totale<\/li>\n\n\n\n<li>Engourdissement, picotement dans les doigts : atteinte vasculo-nerveuse<\/li>\n<\/ul>\n\n\n\n<p><strong>Ecarter la fracture<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Palpation douce cibl\u00e9e : t\u00eate radiale, ol\u00e9crane, \u00e9picondyles<\/li>\n\n\n\n<li>Radio : gold standard<\/li>\n<\/ul>\n\n\n\n<p><strong>Evaluer les ligaments<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Objectiver leur pr\u00e9sence ou non<\/li>\n\n\n\n<li>Estimer la n\u00e9cessit\u00e9 d&rsquo;une chirurgie ou pas<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p>Traitement<\/p>\n\n\n\n<p>T\u00eate radiale<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>R\u00e9duction en supination\/flexion<\/li>\n\n\n\n<li>90% de succ\u00e8s avec r\u00e9duction imm\u00e9diate de la douleur et r\u00e9cup\u00e9ration rapide chez l&rsquo;enfant<\/li>\n\n\n\n<li>Risque de r\u00e9cidive r\u00e9duit avec la croissance<\/li>\n\n\n\n<li>Immobilisation 1 \u00e0 2 semaine avec mobilisation pr\u00e9coce : importance d&rsquo;int\u00e9grer les parents \u00e0 la r\u00e9\u00e9ducation<\/li>\n\n\n\n<li>Pour l&rsquo;adulte : chirurgie ou anesth\u00e9sie en urgence<\/li>\n<\/ul>\n\n\n\n<p>Hum\u00e9ro-ulnaire<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>R\u00e9duction en traction\/flexion avec pouss\u00e9e sur l&rsquo;ol\u00e9crane<\/li>\n\n\n\n<li>Immobilisation 1 \u00e0 2 semaine avec mobilisation pr\u00e9coce<\/li>\n\n\n\n<li>Pour l&rsquo;adulte : chirurgie ou anesth\u00e9sie en urgence<\/li>\n<\/ul>\n\n\n\n<p><strong>R\u00e9\u00e9ducation<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Mobilisation pr\u00e9coce<\/li>\n\n\n\n<li>Renfo prono-supination, pr\u00e9hension<\/li>\n\n\n\n<li>Stabilit\u00e9 dynamique<\/li>\n\n\n\n<li>Importance de la stabilit\u00e9 dans les plan frontal et sagittal<\/li>\n<\/ul>\n\n\n\n<p><strong>Facteurs pronostic<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Type de luxation : simple (90% de r\u00e9cup\u00e9ration fonctionnelle) ou complexe associ\u00e9e des fractures (complication : instabilit\u00e9 r\u00e9siduelle, raideur articulaire s\u00e9quellaire, ossification h\u00e9t\u00e9rotopique)<\/li>\n\n\n\n<li>Qualit\u00e9 de la stabilit\u00e9 post r\u00e9duction : si instabilit\u00e9 r\u00e9siduelle en valgus\/varus, mauvais pronostic pour la suite sans PEC chirurgicale<\/li>\n\n\n\n<li>Qualit\u00e9 des amplitudes et du secteur des amplitudes \u00e0 6 semaines : si raideur, risque de complication \u00e9ventuelle due \u00e0 une ossification h\u00e9t\u00e9rotopique<\/li>\n\n\n\n<li>Evaluation neuro-vasculaire : probl\u00e8me neuro ou d\u00e9ficit moteur persistant peut indiquer un l\u00e9sion complexe n\u00e9cessitant une intervention<\/li>\n<\/ul>\n\n\n\n<p><strong>Chirurgie<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Instabilit\u00e9 persistante (pathognomonique de la rupture ligamentaire)<\/li>\n\n\n\n<li>Farcture<\/li>\n\n\n\n<li>Respect des d\u00e9lais<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"423\" height=\"74\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-103-png.avif\" alt=\"\" class=\"wp-image-3559\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-103-png.avif 423w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-103-300x52.avif 300w\" sizes=\"auto, (max-width: 423px) 100vw, 423px\" \/><\/figure>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Facteurs de risque, \u00e9pid\u00e9miologie et physiopathologie Facteur de risque&#8211; Laxit\u00e9 ou instabilit\u00e9 ligamentaire pr\u00e9-existante&#8211; Sports \u00e0 chuteT\u00eate radiale&#8211; Enfant (1 \u00e0 5 ans), 2 \u00e0 5 cas\/1000\/an : par traction axiale brusque en pronation (\u00ab\u00a0coude&hellip;<\/p>\n<p class=\"more-link-wrapper\"><a href=\"https:\/\/kineaphp.fr\/?p=2621\" class=\"more-link\">Continue Reading<span class=\"screen-reader-text\"> \u00ab\u00a0Luxation\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":[360],"tags":[],"class_list":["post-2621","post","type-post","status-publish","format-standard","hentry","category-pathologie-coude"],"_links":{"self":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/2621","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=2621"}],"version-history":[{"count":4,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/2621\/revisions"}],"predecessor-version":[{"id":3560,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/2621\/revisions\/3560"}],"wp:attachment":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2621"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2621"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2621"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}