Sports clinic Paris
Metro: Saint Marcel
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According to the first survey of outpatient surgery carried out for the General health clinical group and which Le Figaro publishes exclusively the findings, more than eight in ten French are ready to accept this surgical technique to stay only day in the hospital for an operation. Ambulatory surgery is so, for them, "the mode of hospital tomorrow" but also "a sign that medicine progresses." The same proportion finally believes that this technique "should be developed and more frequent." In short, the final results, especially for the French people over 50 who are the most enthusiastic and receptive.
Nine out of ten would be well to call in case of hospitalization! This level is all the more surprising that it is the public with the most likelihood of using them. "In France, too often professionals believe that older people do not like outpatient surgery. Well, that's wrong! "Says Pascal Roch├ę, CEO of General Health group.
The French interest in the hospital at home is good news for the Health Minister, Marisol Touraine, as it goes in the direction of its policy. Following in part the recommendations of the Court of Auditorsin this regard, it aims to have half of the operations are performed on an outpatient in 2016, against just 40% today. With, the key, 1 billion euros in savings hoped for Safely year.
If the minister wants to develop ambulatory surgery is that this technique has many advantages. By shortening hospital stays to a minimum, it reduces the risks of infections acquired locally. In addition, older people can sleep at home on the evening of the intervention, they are less confused if they spend the night in the hotel. It proves that including the first French study on the cruciate ligament surgery in ambulatory, the surgeon Nicolas Lefevre,Clinic of sport, in the fifth arrondissement of Paris.
Wide range of operations
Finally, it allows savings. Not less than 5 billion long-term and after hospital restructuring, calculated the National Agency for Support to performance (ANAP) and the Court of Auditors. And short-term 570 million, according to the Hospital Federation of France (FHF).
Traditionally, the cataract surgery, varicose veins of the hand that are performed as an outpatient. But the range of operations that can be performed has continued to expand. Among the largest increases included the operations of the gall bladder, hernia of the groin or sinuses. Still, surgeons are delayed with respect to patient demand. Less than 46% of French believe it is possible to perform an operation on cruciate ligament in ambulatory ... against 2% maximum in reality. But this figure is up sharply in the most advanced clinics.
An already employed abroad technical
France began to take interest in the ambulatory surgery with thirty years behind the most advanced countries on the subject. In the US, pioneers, surgeons have embarked on this adventure in the 1960s the authorities have been quick to realize the benefits they could derive from the health point of view, but especially in terms of savings. The rise has been meteoric: 10 specialized centers in 1970, it rose to 836 fifteen years later. Today, the ambulatory rate rises to 94%! However, this figure is not fully comparable with the French statistics because it does not overlap the same reality on the ground.
The first European country to have followed suit in the US is the United Kingdom in the 1970s Hospitals were already clogged and had to wait months or even one year for surgery. Institutions were also in need of nurses. Ambulatory surgery is going to be used to reduce these queues and staff requirements.
The countries of continental Europe will not follow the trend in the 1990s the new anesthesia techniques then will shorten pre and postoperative phases. Surgery is no exception, with the development of less invasive techniques.
"Ambulatory surgery does not develop spontaneously, as it modifies the old behaviors and redraws the territories of health actors observes Dr. Gilles Bontemps, associate director of the National Agency to support performance (ANAP). Strong economic hardship faced by the hospital today therefore is an extraordinary opportunity to develop this technique in France, improve the quality of care and cost savings. "
By Guillaume Guichard, graphics Service Figaro Published on 09/17/2014 at 06:02
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..)
The shoulder dislocations and recurrent anterior instability is a common problem among young athletes making up 90% of shoulder dislocations. Surgical indication can be provided in these cases of glenohumeral dislocations previous recurrent, but also in cases of painful and unstable shoulders. A question now arises, should we offer it immediately after the first dislocation or should we expect one or more recurrences? (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..)