Sports clinic Paris
Metro: Saint Marcel
Parking 6 rue test
The information provided on this website is provided by medical professionals: sports doctors, rheumatologists, functional rehabilitation doctors, orthopedic, clinical surgeons sport, podiatrist sports meeting within the group "chirurgiedusport.com"
All histological and animal studies have demonstrated the value of a measured mechanical stress for a ligament scar quality. However, in practice, resin and orthosis can partner effectively!
Here is the story of a sporty and dynamic patient, who suffered a severe ankle sprain. Brave and eager, he is unable to limit the use of his ankle. He takes off his splint few days after injury, when the pain has decreased. After a bit of therapy, her therapist overworked her program immediately in charge of the proprioception and abandons teetering on a freeman tray. The ankle still swollen and painful. However, without waiting for the approval of his doctor, he resumed running, tennis or football. A five or six weeks of the sprain, a possible control ultrasound shows a broken ligament structure embedded in connective magma without functional interest. Ankle appears quite lax and her therapist a good command hopes to limit recurrences proprioceptive! Two months later, he finished an exhausting tennis match, articulation twists violently again. To cause instability or microlaxit├ę in a few years, it will take over his ankle osteoarthritis!
Of course, the functional treatment is not therapeutic abandonment but there are cases where human nature brings some risks to the protocols from histopathological research! The field doctor knows that. Sometimes it proposes to begin 6 weeks of joint mobility reduction through strict asset. In practice, when the sprain includes many severity criteria at the end of the GREC, we begin treatment with 10 to 21 days of rigid or flexible resin. Obviously the support and walking are permitted. This type of care helps limit inflammation and excessive traction on the ligaments. This method does not exclude the muscular work and stress on stabilizing reflexes to avoid the loss of strength and coordination. The new joints from trauma mobilized without limitation.
To comply with these principles, the boot is irremovable. It does not rise above the lower terrain calf and did not cover all of the metatarsals. The sural triceps and side stabilizers can contract. Our sport has easily drainage massages, stimulations excitomotrices well as distal and proximal mobilizations. Proprioceptive work by gradually increasing load begins early without risk. The injured is invited to ride a bike because this activity perfectly tolerates ankle locked at 90 ┬░. This way, it keeps good cardiovascular shape. Isometric contractions or short strokes of the muscles of the leg and foot reduce the risk of adhesion. It can also do weight training of the lower limbs without support (open chain) emphasizing the braking load (eccentric predominance). Thus, our athlete is not embarrassed by its resin and suffer fewer aches for the resumption of the race.
After 10 to 21 days, the resin removal, we often pleased to see that the ankle is fine; often less swollen, less painful after three weeks of tracking poorly functional treatment! To achieve the relative 6 weeks of immobilization, we prescribe an ankle orthosis Bauerfeind kind AirLoc 20 to 35 days. That allows more actively pursue mechanization. An inflatable brace adjusts to better restraint to the morphology of each and residual wheelbase of the joint. By removing the orthosis during rehabilitation sessions, the therapist works directly ligament scar. The dynamic building starts without difficulty. The proprioceptive orthosis is done with binding exercises and without orthosis for less complex techniques.
Equipped with his brace, our sports can now use devices requiring flexion / extension ankle. The orthosis is less troublesome when his lower extremities are fine and do not deform the sports shoe. Many simulators exist in all fitness and are frequently found in physiotherapy room. And rower, stepper and ellipteur gradually enroll in the program. The gesture is similar to that little bit of running. Far from irritating the ligament structure, this work contributes effectively to mechanize the scar. At approximately 4 weeks of trauma, our patient trots minutes with his brace on carpet or even ground. Initially, it is more of rehabilitation to the race as a workout. Meanwhile, it can work intensively on other devices
With braces, the footings are faster and more prolonged. An orthosis comprising an elastic sole seems better tolerated. Gradually, if the ankle has no pain or swelling, the brace is removed for the race on mats or on regular ground. back sessions in the field begin parallel. While sharpening the physical condition of our sport, this step is a real physiotherapy proprioceptive scale. The ligament completes its mechanization and acquires the tissue characteristics essential to its specific mission. The side trips begin on condition of orthosis. The latter is retained to perform new exercises, it is gradually removed when the movements are controlled.
Finally, our patient returns to his favorite sport at about 6 weeks of the trauma ... when histological scar ends. If our sport is concerned, wear a brace quality, well tolerated, allows the first drives with more security. In the heat of the moment, she informed teammates and opponents that player returns from injury. The back trust in our sport quickly forgets to put her brace. Because he is fit, he returned to competition in stride: he won the time! Moreover, his ankle is not swollen or lax. It is painless and stable. In severe sprain, the resin cocktail then brace associated with early rehabilitation and physical maintenance is often very effective!
Rodineau J., G. Saillant 2003
Ligament recent peripheral lesion
This technique of reconstruction of the anterior cruciate ligament plasty involving extra and intra-articular fascia lata was described by Hey-Groves in 1917, modified in 1972 and MacIntosh Jaeger recently. This reconstruction is a technique increasingly practiced for controlling the tibial rotation and rotational jump experienced by the patient and the surgeon objectified by clinical examination.
This lateral grafting used in this technique is called the fascia lata is a transplant with high resistance comparable to other biomechanical transplants used. The fascia lata retains its tibial insertion, which is a natural attachment system and therefore superior to any other system used. This technique has the advantages of not having to levy tendon and therefore the hope of postoperative muscle recovery and normalization of the fastest isokinetic tests.
The coracoid bone block screwed in front of the glenoid realized today either open or arthroscopically.
The advantages of arthroscopic abutment technique are:
- Take stock of the damage to the joint, bead, cartilage, loss of bone substance, tendon injuries
- The precise positioning of the stop because under direct control by the camera,
- Of smaller sizes scars,
- The treatment of lesions as lesions of the biceps (SLAP lesion) or lesions of the rotator cuff (tendon rupture) that can be treated in the same operation
- Early functional recovery
Latarjet arthroscopic intervention
The procedure is most often performed under general anesthesia with an inter-scalene block made ??preoperatively by the anesthetist. It involves taking a bone block of about 2 cm at the expense of the coracoid and place it in the anterior and inferior part of the glenoid cavity, passing through the subscapularis muscle. The coracoid can be positioned upright and secured by a screw according to Bristow or lying and fixed by two screws according Latarjet. (read more..)
PTG MY KNEE INTERVENTION
A preoperative CT scan is performed 3 weeks before the operative date to carry out the cutting guide on measurement of the prosthesis by printing 3D printer. The various bone cuts are made ??using 3D custom cutting guides, then the instrumentation adapted to the selected prosthesis (ancillary equipment), we must ensure the ligament balance and if necessary make releases (release) rarely ligament retentions. (read more ....)
Patient, 58, sporting good level with chronic tendinitis of the Achilles tendon of the left.
chronic Achilles tendon pain lasting for more than a year after a triathlon.
The patient has received medical treatment (necessary before any surgical decision): rehabilitation, Stanish stretching, shock wave, orthopedic soles. (read more...)
While muscle injuries of the posterior region of the thigh are common in athletes, the proximal hamstring rupture is a rare disease. A study published in 2003  analyzed in a consecutive series of 170 patients, 179 trauma hamstrings occurred over a period of 3 years. MRI and / or ultrasound showed that only 12% of the injuries were fractures of the proximal and 9% complete ruptures. It is also little known, the first cases described in the literature from 1988 . Clinically the patients describe a violent pain in the buttock (stab printing) followed by leg weakness. ( To be continued..)