{"id":1324,"date":"2021-01-19T09:31:24","date_gmt":"2021-01-19T09:31:24","guid":{"rendered":"https:\/\/www.djoglobal.eu\/blog\/?p=1324"},"modified":"2021-12-17T10:34:40","modified_gmt":"2021-12-17T10:34:40","slug":"un-accident-de-ski-frequent-lentorse-de-pouce-ou-pouce-du-skieur","status":"publish","type":"post","link":"https:\/\/enovis-medtech.eu\/blog\/un-accident-de-ski-frequent-lentorse-de-pouce-ou-pouce-du-skieur\/","title":{"rendered":"ACCIDENT DE SKI ET ENTORSE DE POUCE"},"content":{"rendered":"\n<p>L\u2019<strong>entorse de l\u2019articulation m\u00e9tacarpo-phalangienne du pouce<\/strong> (MCP) est l\u2019une des blessures les plus fr\u00e9quentes lors de la pratique du ski. \u00c9galement appel\u00e9e \u00ab&nbsp;pouce du skieur&nbsp;\u00bb, elle repr\u00e9sente en effet <strong>75% des l\u00e9sions de la main du skieur<\/strong>, notamment lors de la pratique du ski alpin ou nordique.<\/p>\n\n\n\n<p>Nous allons vous expliquer \u00e0 travers cet article comment cela arrive. Nous verrons \u00e9galement quels sont les sympt\u00f4mes et le traitement \u00e0 suivre pour r\u00e9cup\u00e9rer un pouce en pleine forme&nbsp;!<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Rappel anatomique<\/strong><\/h2>\n\n\n\n<p>L\u2019articulation m\u00e9tacarpo-phalangienne du pouce est la plus complexe des doigts de la main. Non prot\u00e9g\u00e9e comme les autres doigts de la main, cette articulation est <strong>expos\u00e9e aux risques de traumatisme<\/strong> durant le sport.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.djoglobal.eu\/blog\/wp-content\/uploads\/2020\/12\/Planche-Anat-Main-V2-1024x661.jpg\" alt=\"Planche anatomique de la main\" class=\"wp-image-1319\" width=\"618\" height=\"399\" srcset=\"https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/Planche-Anat-Main-V2-1024x661.jpg 1024w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/Planche-Anat-Main-V2-300x194.jpg 300w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/Planche-Anat-Main-V2-768x496.jpg 768w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/Planche-Anat-Main-V2-1536x991.jpg 1536w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/Planche-Anat-Main-V2.jpg 1557w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/figure><\/div>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>Le ligament lat\u00e9ral interne (LLI) prend son origine \u00e0 la face interne du condyle m\u00e9tacarpien. Il se divise en deux faisceaux&nbsp;: <\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><mark>Faisceau principal se termine sur le tubercule lat\u00e9ral de la premi\u00e8re phalange du pouce<\/mark><\/td><\/tr><tr><td><mark>Ligament lat\u00e9ral interne accessoire se termine par le s\u00e9samo\u00efde interne<\/mark><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"468\" height=\"273\" src=\"https:\/\/www.djoglobal.eu\/blog\/wp-content\/uploads\/2020\/12\/RMS_563_1060_fig01.jpg_i770.jpg\" alt=\"Visualisation de l'\u00e9tirement du LLI\" class=\"wp-image-1320 size-full\" srcset=\"https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/RMS_563_1060_fig01.jpg_i770.jpg 468w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/RMS_563_1060_fig01.jpg_i770-300x175.jpg 300w\" sizes=\"auto, (max-width: 468px) 100vw, 468px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p style=\"font-size:17px\">&nbsp;Le LLI est recouvert par la lame apon\u00e9vrotique de l\u2019adducteur du pouce. Le faisceau principal est tendu en flexion, d\u00e9tendu en extension et, inversement, pour le faisceau accessoire. Les mouvements forc\u00e9s d\u2019abduction (chute main en avant tenant le b\u00e2ton, pouce en abduction) sont responsables d\u2019un \u00e9tirement, voire d\u2019une rupture de ce LLI.<\/p>\n<\/div><\/div>\n\n\n\n<p>Dans ce dernier cas, il faut souligner qu\u2019aucune cicatrisation spontan\u00e9e n\u2019est possible. En effet, l\u2019apon\u00e9vrose de l\u2019adducteur emp\u00eache le LLI rompu de se r\u00e9ins\u00e9rer sur la premi\u00e8re phalange.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"635\" height=\"360\" src=\"https:\/\/www.djoglobal.eu\/blog\/wp-content\/uploads\/2020\/12\/RMS_563_1060_fig03.jpg_i770-Effet-Stener.jpg\" alt=\"effet Stener\" class=\"wp-image-1321\" srcset=\"https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/RMS_563_1060_fig03.jpg_i770-Effet-Stener.jpg 635w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/RMS_563_1060_fig03.jpg_i770-Effet-Stener-300x170.jpg 300w\" sizes=\"auto, (max-width: 635px) 100vw, 635px\" \/><\/figure><\/div>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Comment reconna\u00eetre\u00a0les sympt\u00f4mes d&rsquo;une\u00a0entorse de pouce (pouce du skieur)\u00a0?<\/strong><\/h2>\n\n\n\n<div class=\"wp-block-media-text alignwide has-media-on-the-right is-stacked-on-mobile\" style=\"grid-template-columns:auto 26%\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"650\" height=\"434\" src=\"https:\/\/www.djoglobal.eu\/blog\/wp-content\/uploads\/2020\/12\/Mal-au-pouce_72dpi.jpg\" alt=\"Douleur au pouce\" class=\"wp-image-1334 size-full\" srcset=\"https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/Mal-au-pouce_72dpi.jpg 650w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/Mal-au-pouce_72dpi-300x200.jpg 300w\" sizes=\"auto, (max-width: 650px) 100vw, 650px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p style=\"font-size:17px\">Le <strong>premier indicateur de traumatisme est la douleur<\/strong>, souvent intense. Des antalgiques, anti-douleurs et anti-inflammatoires sont souvent prescrits pour calmer la douleur de ce traumatisme.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\" style=\"grid-template-columns:24% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"650\" height=\"568\" src=\"https:\/\/www.djoglobal.eu\/blog\/wp-content\/uploads\/2020\/12\/gonlement-hematome-pouce_72dpi.jpg\" alt=\"H\u00e9matome au pouce\" class=\"wp-image-1355 size-full\" srcset=\"https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/gonlement-hematome-pouce_72dpi.jpg 650w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/gonlement-hematome-pouce_72dpi-300x262.jpg 300w\" sizes=\"auto, (max-width: 650px) 100vw, 650px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p style=\"font-size:17px\">On peut \u00e9galement voir apparaitre rapidement un <strong>gonflement ou un h\u00e9matome<\/strong>, une sensibilit\u00e9 de l\u2019int\u00e9rieur du pouce (c\u00f4t\u00e9 de l\u2019index), la <strong>perte de force et de stabilit\u00e9<\/strong> lors de la prise en main d\u2019objets ce qui rend impossible de s\u2019en servir.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-media-text alignwide has-media-on-the-right is-stacked-on-mobile\" style=\"grid-template-columns:auto 27%\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"717\" src=\"https:\/\/www.djoglobal.eu\/blog\/wp-content\/uploads\/2020\/12\/docteur-patient_72dpi-1024x717.jpg\" alt=\"Consultation m\u00e9dicale\" class=\"wp-image-1323 size-full\" srcset=\"https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/docteur-patient_72dpi-1024x717.jpg 1024w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/docteur-patient_72dpi-300x210.jpg 300w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/docteur-patient_72dpi-768x538.jpg 768w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/docteur-patient_72dpi.jpg 1382w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p style=\"font-size:17px\">Si les sympt\u00f4mes perdurent au-del\u00e0 de 2-3 jours, il est vivement recommand\u00e9 de consulter un professionnel de sant\u00e9.<\/p>\n<\/div><\/div>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Combien de temps dure l\u2019arr\u00eat maladie&nbsp;?<\/strong><\/h2>\n\n\n\n<p>Suivant le m\u00e9tier exerc\u00e9 et le niveau de gravit\u00e9 de la pathologie, l&rsquo;arr\u00eat de travail sera plus ou moins long&nbsp;:<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"745\" height=\"412\" src=\"https:\/\/www.djoglobal.eu\/blog\/wp-content\/uploads\/2020\/12\/TB-arret-travail-pouce-du-skieur.jpg\" alt=\"TB arr\u00eat travail pouce du skieur\" class=\"wp-image-1322\" srcset=\"https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/TB-arret-travail-pouce-du-skieur.jpg 745w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/TB-arret-travail-pouce-du-skieur-300x166.jpg 300w\" sizes=\"auto, (max-width: 745px) 100vw, 745px\" \/><\/figure><\/div>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Quels sont les traitements&nbsp;?<\/strong><\/h2>\n\n\n\n<p>Selon la gravit\u00e9 de l\u2019indication, il existe 2 types de protocoles:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong><em>Traitement non chirurgical<\/em><\/strong><em><\/em><\/li><\/ul>\n\n\n\n<p>Toutes les entorses ne n\u00e9cessitent pas forc\u00e9ment un traitement chirurgical. En effet, la rupture du ligament peut \u00eatre partielle, ce qui ne d\u00e9stabilise pas l\u2019articulation.<\/p>\n\n\n\n<p>Une solution orthop\u00e9dique sera propos\u00e9e pour une immobilisation de 3 semaines : <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>soit par une <a href=\"https:\/\/www.djoglobal.eu\/fr_FR\/Exos-Pouce-II-74441.html\">attelle de pouce thermoformable<\/a><\/li><li>soit par un pl\u00e2tre non amovible qui bloquera l\u2019articulation m\u00e9tacarpo-phalangienne du pouce en laissant le\u00a0poignet\u00a0libre<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.djoglobal.eu\/blog\/wp-content\/uploads\/2020\/12\/Exos-Pouce-II-Interieur-1.jpg\" alt=\"Attelle de pouce EXOS POUCE II - vue interne\" class=\"wp-image-1337\" width=\"327\" height=\"340\" srcset=\"https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/Exos-Pouce-II-Interieur-1.jpg 569w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2020\/12\/Exos-Pouce-II-Interieur-1-289x300.jpg 289w\" sizes=\"auto, (max-width: 327px) 100vw, 327px\" \/><\/figure><\/div>\n\n\n\n<p>Une fois que l\u2019immobilisation sera termin\u00e9e, le patient r\u00e9cup\u00e9rera de mani\u00e8re progressive la mobilit\u00e9 de son pouce. Il devra rester prudent pendant deux mois. Si la mobilit\u00e9 du pouce ne revient pas spontan\u00e9ment, le professionnel de sant\u00e9 prescrira des s\u00e9ances de r\u00e9\u00e9ducation. Celles-ci sont n\u00e9cessaires \u00e0 la bonne r\u00e9cup\u00e9ration de l\u2019articulation.<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<ul class=\"wp-block-list\"><li><strong><em>Traitement chirurgical<\/em><\/strong><\/li><\/ul>\n\n\n\n<p>Il est imp\u00e9ratif de consulter un chirurgien, si possible sp\u00e9cialiste de la main, afin de faire les examens n\u00e9cessaires de mani\u00e8re \u00e0 \u00e9carter toute possibilit\u00e9 de l\u00e9sion grave n\u00e9cessitant une intervention chirurgicale (environ 15 % selon les \u00e9tudes).<\/p>\n\n\n\n<p>Si une op\u00e9ration est \u00e0 envisager, elle est g\u00e9n\u00e9ralement <strong>planifi\u00e9e dans les 10 jours suivant l\u2019accident <\/strong>pour pr\u00e9venir des complications. Toute entorse grave non diagnostiqu\u00e9e et non trait\u00e9e peut laisser des s\u00e9quelles permanentes et \u00e9voluer vers une arthrose douloureuse&nbsp;!<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"209\" height=\"155\" src=\"https:\/\/www.djoglobal.eu\/blog\/wp-content\/uploads\/2020\/12\/Institut-de-la-Main.fr-entorse-du-pouce.gif\" alt=\"Institut de la Main.fr - entorse du pouce\" class=\"wp-image-1318\"\/><figcaption>Source: Institut de la Main<\/figcaption><\/figure><\/div>\n\n\n\n<p>L\u2019hospitalisation se faisant en ambulatoire, la chirurgie se pratique sous anesth\u00e9sie locale. Le protocole post-op\u00e9ratoire impose une immobilisation du pouce pour une dur\u00e9e de 3 \u00e0 6 semaines selon le chirurgien. Des s\u00e9ances de r\u00e9\u00e9ducation seront ensuite propos\u00e9es pour r\u00e9cup\u00e9rer une mobilit\u00e9 compl\u00e8te du pouce comme suit\u00a0:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>R\u00e9\u00e9ducation en flexion-extension \u00e0 partir de la 4\u00e8me&nbsp;semaine<\/strong><\/li><li><strong>Inclinaisons lat\u00e9rales \u00e0 partir de la 6\u00e8me&nbsp;semaine<\/strong><\/li><\/ul>\n\n\n\n<p>La pratique de sport sollicitant l\u2019utilisation du pouce ne sera autoris\u00e9e qu\u2019au bout de 4 mois sous r\u00e9serve de bonne consolidation.<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Peut-on reprendre une activit\u00e9 sportive apr\u00e8s&nbsp;?<\/strong><\/h2>\n\n\n\n<p>Les p\u00e9riodes d&rsquo;immobilisation et de r\u00e9\u00e9ducation doivent bien \u00eatre respect\u00e9es au risque de garder un pouce fragilis\u00e9&nbsp;!<\/p>\n\n\n\n<p>Les inconditionnels du ski ne r\u00e9sisteront pas \u00e0 retourner sur les pistes les saisons suivantes. A titre pr\u00e9ventif, prot\u00e9gez votre pouce qui a d\u00e9j\u00e0 subi une entorse (pouce du skieur). Cela peut \u00eatre via une attelle de pouce id\u00e9alement thermoformable car compl\u00e8tement adapt\u00e9e \u00e0 votre morphologie.<\/p>\n\n\n\n<p>Ce type de dispositif thermoformable est remodelable gr\u00e2ce \u00e0 l\u2019aide d\u2019un four sp\u00e9cifique que vous pouvez d\u00e9couvrir<strong> <a href=\"https:\/\/www.youtube.com\/watch?v=pUBm-ltM1o8&amp;feature=emb_logo\">ICI<\/a><\/strong>. <\/p>\n\n\n\n<p>La douleur est un signe qu\u2019il ne faut pas n\u00e9gliger. Si cette derni\u00e8re est prononc\u00e9e et\/ou perdure trop longtemps, il est conseill\u00e9 de consulter un m\u00e9decin.<\/p>\n\n\n\n<p>Pour plus d\u2019informations sur les solutions th\u00e9rapeutiques existantes, cliquez <a href=\"https:\/\/www.djoglobal.eu\/fr_FR\/Exos-Pouce-II-74441.html\"><strong>ICI<\/strong><\/a><strong>.<\/strong> <\/p>\n\n\n\n<p><a href=\"http:\/\/www.DJOglobal.fr\">www.DJOglobal.fr<\/a><\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wp-block-media-text alignwide has-media-on-the-right is-stacked-on-mobile\" style=\"grid-template-columns:auto 15%\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"831\" height=\"1024\" src=\"https:\/\/www.djoglobal.eu\/blog\/wp-content\/uploads\/2021\/04\/Picto-BV-Bouton-LINKEDIN-Rond-RESEAUX-831x1024.jpg\" alt=\"LinkedIn DJO France\" class=\"wp-image-1498 size-full\" srcset=\"https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2021\/04\/Picto-BV-Bouton-LINKEDIN-Rond-RESEAUX-831x1024.jpg 831w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2021\/04\/Picto-BV-Bouton-LINKEDIN-Rond-RESEAUX-243x300.jpg 243w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2021\/04\/Picto-BV-Bouton-LINKEDIN-Rond-RESEAUX-768x946.jpg 768w, https:\/\/enovis-medtech.eu\/blog\/wp-content\/uploads\/2021\/04\/Picto-BV-Bouton-LINKEDIN-Rond-RESEAUX.jpg 1179w\" sizes=\"auto, (max-width: 831px) 100vw, 831px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p>Abonnez-vous \u00e0 <a rel=\"noreferrer noopener\" href=\"https:\/\/bit.ly\/LinkedInDJOFrance\" target=\"_blank\">notre cha\u00eene LinkedIn<\/a> d\u00e9di\u00e9e uniquement aux professionnels de sant\u00e9 sur laquelle vous retrouverez toute notre actualit\u00e9 hebdomadaire li\u00e9e \u00e0 notre domaine&nbsp;!<\/p>\n<\/div><\/div>\n\n\n\n<p style=\"font-size:12px\"><strong>Auteur&nbsp;<\/strong>: DJO FRANCE &#8211; Janvier 2021<\/p>\n\n\n\n<p style=\"font-size:12px\"><strong>Sources \/ Illustrations&nbsp;:<\/strong><\/p>\n\n\n\n<p style=\"font-size:12px\">Institut de la Main<\/p>\n\n\n\n<p style=\"font-size:12px\">La M\u00e9decine du Sport.com<\/p>\n\n\n\n<p style=\"font-size:12px\">www.ameli.fr<\/p>\n\n\n\n<p style=\"font-size:12px\">Traumatologie du Sport &#8211; 3\u00e8me \u00e9dition Masson<\/p>\n","protected":false},"excerpt":{"rendered":"<p>L\u2019entorse de l\u2019articulation m\u00e9tacarpo-phalangienne du pouce (MCP) est l\u2019une des blessures les plus fr\u00e9quentes lors de la pratique du ski. \u00c9galement appel\u00e9e \u00ab pouce du skieur \u00bb, elle repr\u00e9sente en effet 75% des l\u00e9sions de la main du skieur, notamment lors de la pratique du ski alpin ou nordique.<\/p>\n","protected":false},"author":3,"featured_media":1317,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5],"tags":[159,158,119],"class_list":["post-1324","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-tout-savoir-sur-la-main","tag-douleur-pouce","tag-entorse-du-pouce","tag-pouce-du-skieur"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.2 - 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