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Le doigt \u00e0 ressaut (ou t\u00e9nosynovite nodulaire d\u2019un doigt) est la pathologie de la main la plus fr\u00e9quente apr\u00e8s le syndrome du canal carpien. La symptomatologie peut aller d\u2019une simple g\u00eane douloureuse au niveau de la paume de la main lors des mouvements de flexion et d\u2019extension d\u2019un doigt, jusqu\u2019\u00e0 un blocage douloureux du doigt en flexion, blocage parfois irr\u00e9ductible.<\/p>\n[\/et_pb_text][\/et_pb_column_inner][\/et_pb_row_inner][\/et_pb_column][et_pb_column type=\u00a0\u00bb1_2″ _builder_version=\u00a0\u00bb3.0.47″ padding_phone__hover=\u00a0\u00bb60px|50px||50px||true\u00a0\u00bb padding_tablet__hover=\u00a0\u00bb80px|60px|80px|60px|true|true\u00a0\u00bb padding_last_edited__hover=\u00a0\u00bbon|desktop\u00a0\u00bb padding_left__hover=\u00a0\u00bb100px\u00a0\u00bb padding_right__hover=\u00a0\u00bb15vw\u00a0\u00bb padding_top__hover=\u00a0\u00bb250px\u00a0\u00bb parallax__hover=\u00a0\u00bboff\u00a0\u00bb parallax_method__hover=\u00a0\u00bbon\u00a0\u00bb][et_pb_accordion _builder_version=\u00a0\u00bb3.23.3″][et_pb_accordion_item title=\u00a0\u00bbOrigine\u00a0\u00bb _builder_version=\u00a0\u00bb3.23.3″ open=\u00a0\u00bboff\u00a0\u00bb]

Pour comprendre l\u2019origine du doigt \u00e0 ressaut, il faut conna\u00eetre la disposition anatomique des tendons fl\u00e9chisseurs au niveau des doigts et de la main. Ces tendons font suite au corps musculaire situ\u00e9 \u00e0 l\u2019avant-bras. Ils traversent la paume et se terminent \u00e0 l\u2019extr\u00e9mit\u00e9 des doigts. Lors de la flexion de ces derniers, les tendons fl\u00e9chisseurs ne prennent pas la corde gr\u00e2ce \u00e0 un syst\u00e8me de poulie de r\u00e9flexion \u00ab qui les plaquent contre les phalanges \u00bb. Pour perturber le fonctionnement du syst\u00e8me tendon-poulie, il suffit d\u2019un simple \u00e9paississement du tendon ( appel\u00e9 t\u00e9nosynovite ) pour entra\u00eener une difficult\u00e9 de coulissement du tendon pouvant aller jusqu\u2019au blocage de celui-ci dans la poulie. C\u2019est ce qui se produit lors du doigt \u00e0 ressaut : il s\u2019agit d\u2019une inflammation chronique qui \u00e9tablit un cercle vicieux : le frottement du tendon aggrave l\u2019inflammation, qui \u00e9paissit le tendon, augmentant ainsi le frottement. Il se cr\u00e9e un nodule sur le trajet tendineux qui va bloquer le coulissement du tendon dans la poulie occasionnant un blocage douloureux en flexion du doigt.<\/p>[\/et_pb_accordion_item][et_pb_accordion_item title=\u00a0\u00bbLes causes\u00a0\u00bb _builder_version=\u00a0\u00bb3.23.3″ open=\u00a0\u00bboff\u00a0\u00bb]

L\u2019inflammation chronique n\u00e9cessaire \u00e0 l\u2019apparition d\u2019un doigt \u00e0 ressaut peut avoir comme causes :<\/p>\n

– un geste manuel r\u00e9p\u00e9titif ou intensif<\/p>\n

– une infection d\u2019un doigt<\/p>\n

– un ant\u00e9c\u00e9dent de plaie dans la zone du syst\u00e8me tendon-poulie<\/p>\n

– une maladie inflammatoire ( polyarthrite rhumato\u00efde )<\/p>\n

– un diab\u00e8te<\/p>\n

– plus rarement le doigt \u00e0 ressaut peut-\u00eatre cong\u00e9nital, avec une pr\u00e9dominance d\u2019atteinte sur le pouce.<\/p>[\/et_pb_accordion_item][et_pb_accordion_item title=\u00a0\u00bbSignes pr\u00e9curseurs caract\u00e9ristiques\u00a0\u00bb _builder_version=\u00a0\u00bb3.23.3″ open=\u00a0\u00bboff\u00a0\u00bb]

Le premier signe du doigt \u00e0 ressaut est souvent une douleur situ\u00e9e \u00e0 la base du doigt c\u00f4t\u00e9 paume ( face palmaire ). Exercer une pression sur cette zone peut d\u00e9clencher ou accentuer cette douleur. Elle est situ\u00e9e dans la zone de conflit entre le tendon et la poulie, zone o\u00f9 va s\u2019installer l\u2019inflammation et le nodule.<\/p>[\/et_pb_accordion_item][et_pb_accordion_item title=\u00a0\u00bbSignes\u00a0\u00bb _builder_version=\u00a0\u00bb3.23.3″ open=\u00a0\u00bboff\u00a0\u00bb]

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On peut constater soit un retard \u00e0 l\u2019extension du doigt, soit un blocage du doigt en flexion, qui se redresse avec un ph\u00e9nom\u00e8ne de ressaut. Dans les formes les plus \u00e9volu\u00e9es, on retrouve un blocage irr\u00e9ductible du doigt en flexion.<\/p>\n

A l\u2019examen clinique, le m\u00e9decin peut le constater de visu en faisant mobiliser le doigt du patient. L\u2019examen retrouve une douleur en paume de main dans l\u2019axe du doigt \u00e0 ressaut mais aussi la pr\u00e9sence d\u2019une grosseur correspondant au nodule tendineux.<\/p>\n<\/div>[\/et_pb_accordion_item][et_pb_accordion_item title=\u00a0\u00bbTraitement m\u00e9dical \u00a0\u00bb _builder_version=\u00a0\u00bb3.23.3″ open=\u00a0\u00bboff\u00a0\u00bb]

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Lorsque les douleurs sont apparues apr\u00e8s un effort inhabituel prolong\u00e9 et r\u00e9cent, un traitement associant repos du doigt, m\u00e9dication antalgique et anti-inflammatoire est suffisant dans un premier temps. Il permet d\u2019endiguer le ph\u00e9nom\u00e8ne inflammatoire.<\/p>\n

Lorsque la symptomatologie s\u2019est install\u00e9e depuis plusieurs semaines voire plusieurs mois, une infiltration de cortico\u00efdes dans la gaine tendineuse enflamm\u00e9e peut s\u2019av\u00e9rer n\u00e9cessaire, lorsqu\u2019il n\u2019y a pas de contre-indication (allergie, diab\u00e8te \u2026). C\u2019est une m\u00e9thode efficace quoique relativement douloureuse, consistant \u00e0 att\u00e9nuer l\u2019inflammation locale.<\/p>\n

Ces traitements anti-inflammatoires (par prise orale, par injection) ne seront efficaces que dans la mesure o\u00f9 il n\u2019y a pas de blocage douloureux.<\/p>\n<\/div>[\/et_pb_accordion_item][et_pb_accordion_item title=\u00a0\u00bbTraitement chirurgical\u00a0\u00bb _builder_version=\u00a0\u00bb3.23.3″ open=\u00a0\u00bbon\u00a0\u00bb]

En cas d\u2019inefficacit\u00e9 des traitements anti-inflammatoires ou en cas de blocage douloureux en flexion du doigt, une intervention chirurgicale devra \u00eatre r\u00e9alis\u00e9e et aura lieu sous anesth\u00e9sie loco r\u00e9gionale, en ambulatoire. Elle consiste en l\u2019ex\u00e9r\u00e8se du nodule et de l\u2019inflammation p\u00e9ri-tendineuse. Elle est r\u00e9alis\u00e9e par une chirurgie mini invasive (mini incision) qui permet une r\u00e9utilisation imm\u00e9diate du doigt op\u00e9r\u00e9 apr\u00e8s l\u2019intervention. La disparition du blocage est aussi imm\u00e9diate. Quelques s\u00e9ances de r\u00e9\u00e9ducation sont r\u00e9alis\u00e9es afin de permettre une r\u00e9cup\u00e9ration encore plus rapide. Le plus souvent, elle est compl\u00e8te \u00e0 trois semaines environ. Il n\u2019y a classiquement pas de douleurs post-op\u00e9ratoires. Les complications sont rares.<\/p>[\/et_pb_accordion_item][\/et_pb_accordion][\/et_pb_column][\/et_pb_section]","protected":false},"excerpt":{"rendered":"

Le doigt \u00e0 ressaut (ou t\u00e9nosynovite nodulaire d\u2019un doigt) est la pathologie de la main la plus fr\u00e9quente apr\u00e8s le syndrome du canal carpien. La symptomatologie peut aller d\u2019une simple g\u00eane douloureuse au niveau de la paume de la main lors des mouvements de flexion et d\u2019extension d\u2019un doigt, jusqu\u2019\u00e0 un blocage douloureux du doigt […]<\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":""},"yoast_head":"\nDoigt \u00e0 ressaut - Hallux Valgus Nice | Chirurgie pied Nice<\/title>\n<meta name=\"description\" content=\"Dr Becquet Chirurgien du Pied \u00e0 Nice. Informations sur la chirurgie du pied \/ mini-invasive et percutan\u00e9e \/ Hallux Valgus | Nice. 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