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Contattateci<\/h1>\n

Se avete domande o suggerimenti, utilizzate il nostro modulo di contatto.<\/p>\n[\/et_pb_text][et_pb_button button_text=\u00a0\u00bbcontactez-nous\u00a0\u00bb _builder_version=\u00a0\u00bb3.23.3″ custom_button=\u00a0\u00bbon\u00a0\u00bb button_text_size=\u00a0\u00bb16px\u00a0\u00bb button_text_color=\u00a0\u00bb#ffffff\u00a0\u00bb button_bg_color=\u00a0\u00bb#62de9d\u00a0\u00bb button_border_width=\u00a0\u00bb5px\u00a0\u00bb button_border_color=\u00a0\u00bbrgba(0,0,0,0)\u00a0\u00bb button_border_radius=\u00a0\u00bb5px\u00a0\u00bb button_letter_spacing=\u00a0\u00bb2px\u00a0\u00bb button_font=\u00a0\u00bbWork Sans|600||on|||||\u00a0\u00bb button_use_icon=\u00a0\u00bboff\u00a0\u00bb custom_margin=\u00a0\u00bb30px||\u00a0\u00bb custom_padding=\u00a0\u00bb10px|25px|10px|25px|true|true\u00a0\u00bb button_bg_color__hover_enabled=\u00a0\u00bbon\u00a0\u00bb button_bg_color__hover=\u00a0\u00bb#82ddb0″ 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Stabilit\u00e0 laterale dell'articolazione
<\/strong><\/h2>\n

La stabilit\u00e0 laterale dell'articolazione metacarpo-falangea del pollice \u00e8 particolarmente importante nel pinch pollice-indice. Questa stabilit\u00e0 dell'articolazione dipende dall'integrit\u00e0 dei legamenti laterali: il legamento collaterale mediale (situato sul lato indice)
che \u00e8 pi\u00f9 frequentemente interessato da traumi (9 casi su 10) e il legamento collaterale laterale.<\/p>\n

Il termine \"distorsione\" comprende tutti i danni alle strutture legamentose, dal semplice stiramento alla rottura completa (distorsione grave) del legamento laterale dell'articolazione metacarpo-falangea del pollice.<\/p>\n

Meccanismo di lesione<\/p>\n

Le distorsioni del legamento collaterale mediale si verificano in seguito a un trauma che provoca un improvviso spostamento del pollice verso l'esterno. Si tratta di una condizione estremamente comune, che nella maggior parte dei casi \u00e8 il risultato di un incidente sportivo, in particolare di una caduta sugli sci (il pollice cade nella neve con il resto del corpo, che continua a scivolare, oppure il pollice si gira e rimane incastrato nella cinghia del bastoncino da sci). Immagini simili si riscontrano negli sport con la palla.<\/p>\n[\/et_pb_text][\/et_pb_column][\/et_pb_section][et_pb_section fb_built=\u00a0\u00bb1″ admin_label=\u00a0\u00bbVideo\u00a0\u00bb _builder_version=\u00a0\u00bb3.23.3″ background_image=\u00a0\u00bbhttp:\/\/hallux-valgus-nice.fr\/wp-content\/uploads\/2019\/06\/health-clinic-88.jpg\u00a0\u00bb background_size=\u00a0\u00bbinitial\u00a0\u00bb custom_padding=\u00a0\u00bb0px|0px|100px|0px|false|false\u00a0\u00bb custom_width_px__hover=\u00a0\u00bb1080px\u00a0\u00bb custom_width_px__hover_enabled=\u00a0\u00bb1080px\u00a0\u00bb custom_width_percent__hover=\u00a0\u00bb80%\u00a0\u00bb custom_width_percent__hover_enabled=\u00a0\u00bb80%\u00a0\u00bb gutter_width__hover=\u00a0\u00bb3″ gutter_width__hover_enabled=\u00a0\u00bb3″ parallax_1__hover=\u00a0\u00bboff\u00a0\u00bb parallax_1__hover_enabled=\u00a0\u00bboff\u00a0\u00bb parallax_2__hover=\u00a0\u00bboff\u00a0\u00bb parallax_2__hover_enabled=\u00a0\u00bboff\u00a0\u00bb 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_builder_version=\u00a0\u00bb3.23.3″][et_pb_accordion _builder_version=\u00a0\u00bb3.23.3″][et_pb_accordion_item title=\u00a0\u00bbQuels sont les signes cliniques d\u2019une entorse grave du pouce ?\u00a0\u00bb _builder_version=\u00a0\u00bb3.23.3″ open=\u00a0\u00bboff\u00a0\u00bb]

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Il pollice \u00e8 doloroso, spesso molto doloroso, ma il gonfiore \u00e8 spesso minimo.<\/p>\n

I pazienti devono essere consapevoli che non esiste una correlazione tra la gravit\u00e0 del dolore e la gravit\u00e0 della distorsione. Un pollice molto doloroso pu\u00f2 corrispondere a una semplice lesione da stiramento del legamento, mentre un dolore moderato pu\u00f2 essere associato a una rottura completa del legamento collaterale mediale. La diagnosi di gravit\u00e0 deve essere fatta da uno specialista dopo un esame comparativo della lassit\u00e0 delle due articolazioni metacarpo-falangee. Una chiara instabilit\u00e0 laterale all'esame clinico indica la rottura del legamento e richiede la riparazione chirurgica del legamento collaterale mediale. A differenza del legamento collaterale laterale, che guarisce da solo dopo una lacerazione traumatica, il legamento collaterale mediale ha una particolare configurazione anatomica che gli impedisce di riattaccarsi da solo alla base della falange una volta strappato. Questo fenomeno \u00e8 noto come effetto Stenner.<\/p>\n<\/div>[\/et_pb_accordion_item][et_pb_accordion_item title=\u00a0\u00bbQuels sont les examens compl\u00e9mentaires utiles au diagnostic ?\u00a0\u00bb _builder_version=\u00a0\u00bb3.23.3″ open=\u00a0\u00bboff\u00a0\u00bb]

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Una radiografia standard \u00e8 essenziale per escludere una frattura associata a distorsione.<\/p>\n

In caso di esitazione sulla diagnosi, in particolare nei pazienti iperlax, si eseguono radiografie standard da sforzo (in una posizione forzata che riproduce il meccanismo iniziale del trauma) per confermare che la lassit\u00e0 laterale non \u00e8 aumentata sul lato traumatizzato.<\/p>\n

L'ecografia non viene eseguita di routine. Viene eseguita solo in caso di dubbio sulla diagnosi.<\/p>\n<\/div>[\/et_pb_accordion_item][et_pb_accordion_item title=\u00a0\u00bbQuel est le traitement ?\u00a0\u00bb _builder_version=\u00a0\u00bb3.23.3″ open=\u00a0\u00bboff\u00a0\u00bb]

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Dipende dalla gravit\u00e0 della distorsione.<\/p>\n

Le distorsioni minori (semplice stiramento del legamento) e moderate (rottura parziale del legamento collaterale mediale) vengono trattate con un'ortesi termoformata su misura che immobilizza l'articolazione metacarpo-falangea del pollice e lascia libero il polso rispettivamente per sette-dieci giorni e tre settimane. \u00c8 prevista anche un'adeguata riabilitazione.<\/p>\n

Invece, in caso di distorsione grave (rottura completa del legamento collaterale mediale), il trattamento sar\u00e0 sistematicamente chirurgico. Non si tratta di un'emergenza assoluta. La sutura del legamento pu\u00f2 essere eseguita entro dieci giorni dal trauma, senza alcuna difficolt\u00e0 tecnica. Oltre, il rischio di retrazione del legamento pu\u00f2 rendere la riparazione chirurgica pi\u00f9 difficile o addirittura impossibile. Sar\u00e0 necessario un intervento leggermente pi\u00f9 complicato (legamentoplastica).<\/p>\n

L'intervento viene eseguito in anestesia loco-regionale (solo l'arto operato viene addormentato), in regime ambulatoriale (il paziente non dorme in clinica).<\/p>\n

Dopo l'intervento, il pollice deve essere immobilizzato per sei settimane. Dopo questa fase di immobilizzazione, saranno necessarie sessioni di rieducazione specifiche per ripristinare la flessibilit\u00e0 e la mobilit\u00e0 della colonna del pollice.<\/p>\n

Gli sport pesanti o le attivit\u00e0 professionali (lavori manuali o pesanti) saranno vietati per tre mesi. Lo sport deve essere ripreso con l'uso di reggette all'inizio.<\/p>\n

Dopo l'intervento possono essere necessari fino a sei mesi perch\u00e9 il dolore scompaia, oppure in alcuni casi pu\u00f2 persistere sotto forma di dolore reumatico (comparsa di fastidio in caso di pioggia).<\/p>\n

Va notato che l'articolazione lesionata rimane permanentemente gonfia: infatti, la cicatrice del legamento \u00e8 pi\u00f9 spessa del legamento iniziale, conferendo al pollice un aspetto gonfio.<\/p>\n<\/div>\n

.<\/p>\n[\/et_pb_accordion_item][et_pb_accordion_item title=\u00a0\u00bbQuels sont les risques encourus en cas de m\u00e9connaissance d\u2019une entorse grave de l\u2019articulation m\u00e9tacarpophalangienne du pouce ?\u00a0\u00bb _builder_version=\u00a0\u00bb3.23.3″ open=\u00a0\u00bbon\u00a0\u00bb]

Purtroppo si tratta di un'evenienza molto comune. Molti pazienti che hanno subito una grave distorsione non diagnosticata e che essi stessi non ricordano pi\u00f9, consultano un medico a medio o lungo termine a causa dell'insorgere di un dolore invalidante nella vita quotidiana. Inizialmente, il dolore si attenua dopo il trauma iniziale e i pazienti si adattano all'instabilit\u00e0 dell'articolazione (legata alla mancata riparazione del legamento collaterale mediale). Questa instabilit\u00e0 comporta una perdita di forza e spesso la sensazione che il pollice tenda a \"perdere\" quando si afferra con la pinza pollice-indice. A poco a poco, il paziente avvertir\u00e0 un dolore legato all'usura precoce dell'articolazione (osteoartrite). L'osteoartrite si manifesta pi\u00f9 rapidamente nel pollice perch\u00e9 \u00e8 il dito pi\u00f9 utilizzato della mano ed \u00e8 anche un'articolazione che opera in aree ad alta mobilit\u00e0.<\/p>\n[\/et_pb_accordion_item][\/et_pb_accordion][\/et_pb_column][\/et_pb_row][\/et_pb_section]","protected":false},"excerpt":{"rendered":"

Nous contacter Si vous avez une question, une suggestion, veuillez nous \u00e9crire via notre formulaire. La stabilit\u00e9 lat\u00e9rale de l\u2019articulation La stabilit\u00e9 lat\u00e9rale de l\u2019articulation m\u00e9tacarpophalangienne du pouce est particuli\u00e8rement importante dans la r\u00e9alisation de la pince pouce-index. Cette stabilit\u00e9 articulaire est conditionn\u00e9e par l\u2019int\u00e9grit\u00e9 des ligaments lat\u00e9raux : le ligament lat\u00e9ral interne (situ\u00e9 c\u00f4t\u00e9 […]<\/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":"\nEntorse grave du pouce - Hallux Valgus Nice | Chirurgie pied Nice<\/title>\n<meta name=\"description\" content=\"Dr Becquet Chirurgien du Pied \u00e0 Nice. 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