{"id":4686,"date":"2023-01-26T16:26:34","date_gmt":"2023-01-26T16:26:34","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/plantar-plate-injuries-fr\/"},"modified":"2023-03-17T19:54:10","modified_gmt":"2023-03-17T19:54:10","slug":"plantar-plate-injuries-fr","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/fr\/plantar-plate-injuries-fr\/","title":{"rendered":"Les l\u00e9sions de la plaque plantaire"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\"><b>\u00c9diteur original <\/b>&#8211; <a title=\"User:Ewa Jaraczewska\" href=\"\/User:Ewa_Jaraczewska\">Ewa Jaraczewska<\/a> d&rsquo;apr\u00e8s le cours de <a class=\"external text\" href=\"https:\/\/members.physio-pedia.com\/instructor\/helene-simpson\/\" rel=\"nofollow\">Helene Simpson<\/a><br \/>\n<b>Principaux contributeurs<\/b> &#8211; <a class=\"mw-userlink\" title=\"User:Ewa Jaraczewska\" href=\"\/User:Ewa_Jaraczewska\"><bdi>Ewa Jaraczewska<\/bdi><\/a> et <a class=\"mw-userlink\" title=\"User:Jess Bell\" href=\"\/User:Jess_Bell\"><bdi>Jess Bell<\/bdi><\/a><\/div>\n<div id=\"toc\" class=\"toc\" role=\"navigation\" aria-labelledby=\"mw-toc-heading\"><input id=\"toctogglecheckbox\" class=\"toctogglecheckbox\" style=\"display: none;\" role=\"button\" type=\"checkbox\"><\/p>\n<div class=\"toctitle\" dir=\"ltr\" lang=\"en\">\n<h2 id=\"mw-toc-heading\">Contenu<\/h2>\n<\/div>\n<ul>\n<li class=\"toclevel-1 tocsection-1\"><a href=\"#Introduction\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">Introduction<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-2\"><a href=\"#Clinically_Relevant_Anatomy\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">Anatomie cliniquement pertinente<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-3\"><a href=\"#Mechanism_of_Injury_.2F_Pathological_Process\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">M\u00e9canisme de la l\u00e9sion \/ Processus pathologique<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-4\"><a href=\"#Clinical_Presentation\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">Pr\u00e9sentation clinique<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-5\"><a href=\"#Diagnostic_Procedures\"><span class=\"tocnumber\">5<\/span> <span class=\"toctext\">Proc\u00e9dures diagnostiques<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-6\"><a href=\"#Assessment\"><span class=\"tocnumber\">6<\/span> <span class=\"toctext\">\u00c9valuation<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-7\"><a href=\"#Interview\"><span class=\"tocnumber\">6.1<\/span> <span class=\"toctext\">Entretien<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-8\"><a href=\"#Observation.2FPalpation\"><span class=\"tocnumber\">6.2<\/span> <span class=\"toctext\">Observation \/ Palpation<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-9\"><a href=\"#Tests\"><span class=\"tocnumber\">6.3<\/span> <span class=\"toctext\">Tests<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-10\"><a href=\"#Management_.2F_Interventions\"><span class=\"tocnumber\">7<\/span> <span class=\"toctext\">Traitement et Interventions<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-11\"><a href=\"#Other_Interventions\"><span class=\"tocnumber\">7.1<\/span> <span class=\"toctext\">Autres interventions<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-12\"><a href=\"#Resources\"><span class=\"tocnumber\">8<\/span> <span class=\"toctext\">Ressources<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-13\"><a href=\"#References\"><span class=\"tocnumber\">9<\/span> <span class=\"toctext\">R\u00e9f\u00e9rences<\/span><\/a><\/li>\n<\/ul>\n<\/div>\n<h2><span id=\"Introduction\" class=\"mw-headline\">Introduction<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Introduction\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=1\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Introduction\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=1\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Le complexe de la plaque plantaire est essentiel pour la m\u00e9canique du pied. <sup id=\"cite_ref-:1_1-0\" class=\"reference\"><a href=\"#cite_note-:1-1\">(1)<\/a><\/sup> Il comprend l&rsquo;aspect plantaire de la premi\u00e8re articulation m\u00e9tatarso-phalangienne. Il assure la stabilit\u00e9 dynamique et statique de l&rsquo;articulation tout en prot\u00e9geant les surfaces articulaires de celle-ci. <sup id=\"cite_ref-:1_1-1\" class=\"reference\"><a href=\"#cite_note-:1-1\">(1)<\/a><\/sup> Les plaques plantaires des autres orteils assurent \u00e9galement la stabilit\u00e9 des articulations et la protection des surfaces articulaires. Lorsqu&rsquo;ils abordent les pathologies de la plaque plantaire, les cliniciens doivent reconna\u00eetre deux cat\u00e9gories de blessures : les l\u00e9sions de la premi\u00e8re articulation m\u00e9tatarso-phalangienne (du gros orteil) et les l\u00e9sions des articulations m\u00e9tatarso-phalangiennes des deuxi\u00e8me au cinqui\u00e8me orteil.<sup id=\"cite_ref-:0_2-0\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/p>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/e\/e1\/Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\/300px-Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/e\/e1\/Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\/450px-Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/e\/e1\/Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\/600px-Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg 2x\" alt=\"\" width=\"300\" height=\"347\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Plaque plantaire<\/p>\n<\/div>\n<\/div>\n<\/div>\n<h2><span id=\"Clinically_Relevant_Anatomy\" class=\"mw-headline\">Anatomie cliniquement pertinente <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinically Relevant Anatomy\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=2\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Clinically Relevant Anatomy\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=2\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Le <i>complexe de la plaque plantaire<\/i> a une attache distale \u00e9paisse \u00e0 la base des phalanges proximales au niveau des pieds. La fine attache proximale s&rsquo;\u00e9tend jusqu&rsquo;\u00e0 la jonction t\u00eate-col m\u00e9tatarsienne ou jusqu&rsquo;au ligament inters\u00e9samo\u00efdien. Elle est ins\u00e9parable de la capsule plantaire, des ligaments et des structures musculotendineuses. Elle fournit un syst\u00e8me d&rsquo;amortissement pour les t\u00eates m\u00e9tatarsiennes et les emp\u00eache de glisser vers le sol. <sup id=\"cite_ref-:2_3-0\" class=\"reference\"><a href=\"#cite_note-:2-3\">(3) <\/a><\/sup><sup id=\"cite_ref-:1_1-2\" class=\"reference\"><a href=\"#cite_note-:1-1\">(1)<\/a><\/sup> <i>Les plaques plantaires des quatre derniers orteils<\/i> sont un seul \u00e9paississement capsulaire fibrocartilagineux dominant et s&rsquo;\u00e9tendent de la t\u00eate m\u00e9tatarsienne \u00e0 la base de la phalange proximale \u00e0 chaque articulation.<\/p>\n<p>Le <b>complexe de la plaque plantaire<\/b> est un coussinet fibrocartilagineux qui se compose de trois parties : osseuse, ligamentaire et musculotendineuse. <sup id=\"cite_ref-:0_2-1\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/p>\n<p>La partie osseuse comprend :<\/p>\n<ul>\n<li>Les os s\u00e9samo\u00efdes m\u00e9dial et lat\u00e9ral<\/li>\n<li>Les <a class=\"mw-redirect\" title=\"Foot Anatomy\" href=\"\/Foot_Anatomy\">phalanges proximales<\/a><\/li>\n<li>Les surfaces articulaires des <a title=\"Metatarsals\" href=\"\/Metatarsals\">t\u00eates m\u00e9tatarsiennes<\/a><\/li>\n<\/ul>\n<p>La partie <b>ligamentaire<\/b> comprend :<\/p>\n<ul>\n<li>Les ligaments s\u00e9samo\u00efdes phalangiens : les ligaments les plus \u00e9pais de la premi\u00e8re articulation m\u00e9tatarso-phalangienne. Ils emp\u00eachent la subluxation proximal des os s\u00e9samo\u00efdes lors de l&rsquo;hyperextension pendant la marche ou la course<sup id=\"cite_ref-:1_1-3\" class=\"reference\"><a href=\"#cite_note-:1-1\">(1)<\/a><\/sup><\/li>\n<li>Le ligament inters\u00e9samo\u00efdien : des faisceaux transversaux de fibres de collag\u00e8ne reliant les deux os s\u00e9samo\u00efdes<sup id=\"cite_ref-:1_1-4\" class=\"reference\"><a href=\"#cite_note-:1-1\">(1)<\/a><\/sup><\/li>\n<li>Les ligaments m\u00e9tatarso-samoidiens appari\u00e9s : sont aussi appel\u00e9s ligaments suspenseurs. Leur r\u00f4le est d&rsquo;aider \u00e0 la stabilisation des os s\u00e9samo\u00efdes<sup id=\"cite_ref-:1_1-5\" class=\"reference\"><a href=\"#cite_note-:1-1\">(1)<\/a><\/sup><\/li>\n<\/ul>\n<p>La partie <b>musculotendineuse<\/b> se compose des \u00e9l\u00e9ments suivants :<\/p>\n<ul>\n<li>Les chefs m\u00e9dial et lat\u00e9ral du <a title=\"Flexor Hallucis Brevis\" href=\"\/Flexor_Hallucis_Brevis\">court fl\u00e9chisseur de l&rsquo;hallux<\/a> qui ont une attache proximale sur les surfaces proximale et plantaire des os s\u00e9samo\u00efdes m\u00e9dial et lat\u00e9ral <sup id=\"cite_ref-:1_1-6\" class=\"reference\"><a href=\"#cite_note-:1-1\">(1)<\/a><\/sup><\/li>\n<li>Le <a title=\"Flexor hallucis longus\" href=\"\/Flexor_hallucis_longus\">long fl\u00e9chisseur de l&rsquo;hallux<\/a> qui a une insertion \u00e0 la base de la phalange distale <sup id=\"cite_ref-:1_1-7\" class=\"reference\"><a href=\"#cite_note-:1-1\">(1)<\/a><\/sup><\/li>\n<li>L&rsquo;<a title=\"Adductor Hallucis\" href=\"\/Adductor_Hallucis\">adducteur de l&rsquo;hallux<\/a> dont l&rsquo;insertion principale se situe au niveau des os s\u00e9samo\u00efdes <sup id=\"cite_ref-:1_1-8\" class=\"reference\"><a href=\"#cite_note-:1-1\">(1)<\/a><\/sup><\/li>\n<li>L&rsquo;<a title=\"Abductor Hallucis\" href=\"\/Abductor_Hallucis\">abducteur de l&rsquo;hallux<\/a> qui s&rsquo;ins\u00e8re au niveau des os s\u00e9samo\u00efdes <sup id=\"cite_ref-:0_2-2\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/li>\n<\/ul>\n<p><b>Les structures de soutien<\/b> du complexe de la plaque plantaire incluent :<\/p>\n<ul>\n<li>Les ligaments m\u00e9tatarso-phalangiens m\u00e9dial et lat\u00e9ral (ligaments collat\u00e9raux) :\n<ul>\n<li>Ils ne font pas partie du complexe de la plaque plantaire<\/li>\n<li>Ils agissent comme stabilisateurs statiques lorsque des forces en valgus ou varus sont appliqu\u00e9es<\/li>\n<\/ul>\n<\/li>\n<li><a title=\"Long extenseur de l'hallux\" href=\"\/Extensor_Hallucis_Longus\">Le long extenseur de l&rsquo;hallux<\/a> et <a title=\"Extensor Hallucis Brevis\" href=\"\/Extensor_Hallucis_Brevis\">le court extenseur de l&rsquo;hallux<\/a> :\n<ul>\n<li>Sont des stabilisateurs dynamiques lors de la flexion plantaire<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Le fascia plantaire\n<ul>\n<li>La plaque plantaire est attach\u00e9e \u00e0 la composante centrale de l&rsquo;apon\u00e9vrose plantaire et peut \u00eatre consid\u00e9r\u00e9e comme une extension distale de l&rsquo;apon\u00e9vrose plantaire<sup id=\"cite_ref-4\" class=\"reference\"><a href=\"#cite_note-4\">(4)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>La plaque plantaire est vascularis\u00e9e par le r\u00e9seau vasculaire des tissus mous environnants ; cependant, la partie m\u00e9diane de la plaque plantaire n&rsquo;est pas suffisamment vascularis\u00e9e.<sup id=\"cite_ref-5\" class=\"reference\"><a href=\"#cite_note-5\">(5)<\/a><\/sup><\/p>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Plantar_Plate_Injury_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/c\/c4\/Plantar_Plate_Injury_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\/300px-Plantar_Plate_Injury_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/c\/c4\/Plantar_Plate_Injury_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\/450px-Plantar_Plate_Injury_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/c\/c4\/Plantar_Plate_Injury_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg 2x\" alt=\"\" width=\"300\" height=\"649\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>L\u00e9sion de la plaque plantaire<\/p>\n<\/div>\n<\/div>\n<\/div>\n<h2><span id=\"Mechanism_of_Injury_\/_Pathological_Process\"><\/span><span id=\"Mechanism_of_Injury_.2F_Pathological_Process\" class=\"mw-headline\">M\u00e9canisme de la l\u00e9sion \/ Processus pathologique <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Mechanism of Injury \/ Pathological Process\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=3\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Mechanism of Injury \/ Pathological Process\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=3\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Le <b>complexe de la plaque plantaire de la premi\u00e8re articulation MTP<\/b> peut \u00eatre bless\u00e9 apr\u00e8s un traumatisme aigu ou par un processus chronique et d\u00e9g\u00e9n\u00e9ratif.<\/p>\n<ul>\n<li>Traumatisme aigu\n<ul>\n<li>L\u00e9sions ost\u00e9ochondrales des os s\u00e9samo\u00efdes : <sup id=\"cite_ref-:1_1-9\" class=\"reference\"><a href=\"#cite_note-:1-1\">(1)<\/a><\/sup>\n<ul>\n<li>S\u00e9samo\u00efdite : affection douloureuse et inflammatoire en phase aigu\u00eb, avec scl\u00e9rose en phase chronique<\/li>\n<li>Fractures du s\u00e9samo\u00efde<\/li>\n<li>Diastase d&rsquo;ost\u00e9on\u00e9crose d&rsquo;un s\u00e9samo\u00efde bipartite<\/li>\n<li>L\u00e9sions chondrales avec fragments ost\u00e9ochondraux d\u00e9tach\u00e9s<\/li>\n<\/ul>\n<\/li>\n<li>Hyperextension de l&rsquo;articulation entra\u00eenant une l\u00e9sion des ligaments s\u00e9samo\u00efdes phalangiens <sup id=\"cite_ref-:0_2-3\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup>\n<ul>\n<li>La l\u00e9sion commun\u00e9ment appel\u00e9e \u00a0\u00bbturf toe\u00a0\u00bb est une l\u00e9sion de la premi\u00e8re articulation m\u00e9tatarso-phalangienne (MTP). Elle survient lors d&rsquo;une hyperextension de l&rsquo;articulation MTP, avec un \u00e9quin fixe au niveau de la cheville.<sup id=\"cite_ref-:6_6-0\" class=\"reference\"><\/sup> Lorsqu&rsquo;elle n&rsquo;est pas reconnue, elle peut devenir une affection d\u00e9bilitante accompagn\u00e9e d&rsquo;une douleur persistante, d&rsquo;une d\u00e9formation progressive et d&rsquo;une d\u00e9g\u00e9n\u00e9rescence de l&rsquo;articulation.<sup id=\"cite_ref-:6_6-1\" class=\"reference\"><\/sup> Pour en savoir plus sur le turf toe, cliquez <a title=\"Turf toe\" href=\"https:\/\/www.physio-pedia.com\/Turf_toe\">ici<\/a>.<\/li>\n<\/ul>\n<\/li>\n<li>L\u00e9sions de la surface articulaire de la phalange proximale et de la t\u00eate m\u00e9tatarsienne\n<ul>\n<li>Caus\u00e9e par une charge accrue sur la t\u00eate m\u00e9tatarsienne en position d&rsquo;extension de l&rsquo;articulation m\u00e9tatarso-phalangienne <sup id=\"cite_ref-:2_3-1\" class=\"reference\"><a href=\"#cite_note-:2-3\">(3)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<li>Sauter par terre d&rsquo;une certaine hauteur <sup id=\"cite_ref-:2_3-2\" class=\"reference\"><a href=\"#cite_note-:2-3\">(3)<\/a><\/sup><\/li>\n<li>Blessures souvent observ\u00e9es chez les danseurs ou les sprinters (c&rsquo;est-\u00e0-dire les athl\u00e8tes qui travaillent beaucoup l&rsquo;avant-pied) <sup id=\"cite_ref-:2_3-3\" class=\"reference\"><a href=\"#cite_note-:2-3\">(3)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Processus d\u00e9g\u00e9n\u00e9ratif\n<ul>\n<li><a title=\"Osteoarthritis\" href=\"\/Osteoarthritis\">Osteoarthritis<\/a><\/li>\n<li>D\u00e9formations en <a title=\"L'hallux valgus\" href=\"\/Hallux_Valgus\">hallux valgus<\/a>: d\u00e9viation lat\u00e9rale du gros orteil <sup id=\"cite_ref-:0_2-4\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>D&rsquo;autres pathologies du pied qui surchargent l&rsquo;articulation MTP et provoquent des l\u00e9sions de la plaque plantaire comprennent :\n<ul>\n<li>La pronation excessive<\/li>\n<li>Un premier m\u00e9tatarsien court<\/li>\n<li>Un deuxi\u00e8me m\u00e9tatarsien long<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Les l\u00e9sions les plus courantes des <i>plaques plantaires des quatre derniers orteils<\/i> comprennent les deuxi\u00e8me et troisi\u00e8me plaques plantaires des articulations MTP. Les pathologies sont :<\/p>\n<ul>\n<li>La d\u00e9g\u00e9n\u00e9rescence (\u00e9paississement de la plaque)<\/li>\n<li>Le d\u00e9chirement d&rsquo;une partie de l&rsquo;\u00e9paisseur<\/li>\n<li>Le d\u00e9chirement complet (d\u00e9faut au niveau de l&rsquo;insertion de la plaque)<\/li>\n<\/ul>\n<h2><span id=\"Clinical_Presentation\" class=\"mw-headline\">Pr\u00e9sentation clinique <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinical Presentation\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=4\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Clinical Presentation\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=4\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Les signes et sympt\u00f4mes suivants peuvent indiquer des l\u00e9sions de la plaque plantaire :<\/p>\n<ul>\n<li>Apparition d&rsquo;une douleur et d&rsquo;une sensibilit\u00e9 persistantes, constantes et li\u00e9es \u00e0 l&rsquo;activit\u00e9 au niveau des t\u00eates m\u00e9tatarsiennes (avant-pied) <sup id=\"cite_ref-6\" class=\"reference\"><a href=\"#cite_note-6\">(6) <\/a><\/sup><sup id=\"cite_ref-7\" class=\"reference\"><a href=\"#cite_note-7\">(7) <\/a><\/sup><sup id=\"cite_ref-:3_8-0\" class=\"reference\"><a href=\"#cite_note-:3-8\">(8) <\/a><\/sup><sup id=\"cite_ref-9\" class=\"reference\"><a href=\"#cite_note-9\">(9)<\/a><\/sup><\/li>\n<li>Gonflement sous la plante du pied qui s&rsquo;\u00e9tend vers les orteils<sup id=\"cite_ref-:2_3-4\" class=\"reference\"><a href=\"#cite_note-:2-3\">(3)<\/a><\/sup><\/li>\n<li>Sympt\u00f4mes similaires aux syndromes de compression des nerfs plantaires des orteils, \u00e0 la suite d&rsquo;un microtraumatisme ou d&rsquo;une l\u00e9sion occupant l&rsquo;espace. Les sympt\u00f4mes incluent une sensibilit\u00e9 du talon et de l&rsquo;arche plantaire m\u00e9diale et un engourdissement le long de la partie m\u00e9diale plantaire du pied<sup id=\"cite_ref-10\" class=\"reference\"><a href=\"#cite_note-10\">(10)<\/a><\/sup><\/li>\n<li>\u00c9largissement de l&rsquo;espace interdigital : Le signe de l&rsquo;\u00e9cartement des orteils (signe de Churchill) &#8211; c&rsquo;est-\u00e0-dire qu&rsquo;il y a un plus grand \u00e9cartement entre le 2e et le 3e orteil.<sup id=\"cite_ref-11\" class=\"reference\"><a href=\"#cite_note-11\">(11)<\/a><\/sup><\/li>\n<\/ul>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Churchill_Sign_-_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1481977604.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/1\/1b\/Churchill_Sign_-_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1481977604.jpg\/300px-Churchill_Sign_-_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1481977604.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/1\/1b\/Churchill_Sign_-_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1481977604.jpg\/450px-Churchill_Sign_-_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1481977604.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/1\/1b\/Churchill_Sign_-_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1481977604.jpg\/600px-Churchill_Sign_-_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1481977604.jpg 2x\" alt=\"\" width=\"300\" height=\"246\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Signe de Churchill<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<ul>\n<li>Perte du contact avec le sol : incapacit\u00e9 des orteils \u00e0 toucher le sol normalement<sup id=\"cite_ref-:4_12-0\" class=\"reference\"><a href=\"#cite_note-:4-12\">(12)<\/a><\/sup><\/li>\n<li>Pr\u00e9sence de d\u00e9formations mineures des orteils : \u00e9l\u00e9vation dorsale, orteil crois\u00e9, pronation ou supination<sup id=\"cite_ref-:4_12-1\" class=\"reference\"><a href=\"#cite_note-:4-12\">(12)<\/a><\/sup><\/li>\n<\/ul>\n<h2><span id=\"Diagnostic_Procedures\" class=\"mw-headline\">Proc\u00e9dures de diagnostic <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Diagnostic Procedures\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=5\">modifier<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Diagnostic Procedures\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=5\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Pour confirmer les blessures de la plaque plantaire, les proc\u00e9dures diagnostiques suivantes sont recommand\u00e9es :<\/p>\n<ul>\n<li>Radiographie : r\u00e9alis\u00e9e en position debout pour visualiser les m\u00e9tatarsiens gliss\u00e9s vers le sol<\/li>\n<li>\u00c9chographie : consid\u00e9r\u00e9e comme un outil de premi\u00e8re ligne pour localiser et caract\u00e9riser rapidement et pr\u00e9cis\u00e9ment les pathologies de l&rsquo;avant-pied.<sup id=\"cite_ref-:3_8-1\" class=\"reference\"><a href=\"#cite_note-:3-8\">(8)<\/a><\/sup> L&rsquo;utilisation de techniques d&rsquo;\u00e9chographie statique et dynamique est courante pour \u00e9valuer la pathologie de la plaque plantaire, l&rsquo;\u00e9valuation dynamique offrant une plus grande sensibilit\u00e9.<sup id=\"cite_ref-13\" class=\"reference\"><a href=\"#cite_note-13\">(13)<\/a><\/sup> Un d\u00e9faut partiel ou complet de la plaque plantaire est la pr\u00e9sentation la plus courante d&rsquo;une d\u00e9chirure de la plaque plantaire qui peut \u00eatre facilement d\u00e9tect\u00e9e par \u00e9chographie<sup id=\"cite_ref-:5_14-0\" class=\"reference\"><a href=\"#cite_note-:5-14\">(14)<\/a><\/sup><\/li>\n<li>Tomodensitom\u00e9trie (CT scan) : peut \u00eatre utilis\u00e9e dans les situations difficiles o\u00f9 une intervention chirurgicale est n\u00e9cessaire pour traiter une l\u00e9sion de la plaque plantaire. Il s&rsquo;agit d&rsquo;une proc\u00e9dure diagnostique de choix en pr\u00e9sence de signes et de sympt\u00f4mes de l\u00e9sions des tissus mous<sup id=\"cite_ref-:2_3-5\" class=\"reference\"><a href=\"#cite_note-:2-3\">(3)<\/a><\/sup><\/li>\n<li>Imagerie par r\u00e9sonance magn\u00e9tique (IRM) : tr\u00e8s pr\u00e9cise pour le diagnostic des l\u00e9sions de la plaque plantaire. C&rsquo;est une proc\u00e9dure privil\u00e9gi\u00e9e pour diff\u00e9rencier une blessure de la plaque plantaire d&rsquo;un n\u00e9vrome de Morton <sup id=\"cite_ref-:2_3-6\" class=\"reference\"><a href=\"#cite_note-:2-3\">(3) <\/a><\/sup><sup id=\"cite_ref-:0_2-5\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/li>\n<\/ul>\n<h2><span id=\"Assessment\" class=\"mw-headline\">\u00c9valuation<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Assessment\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=6\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Assessment\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=6\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<h3><span id=\"Interview\" class=\"mw-headline\">Entretien<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Interview\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=7\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Interview\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=7\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Le recueil des ant\u00e9c\u00e9dents du patient est un excellent point de r\u00e9f\u00e9rence. <sup id=\"cite_ref-:2_3-7\" class=\"reference\"><a href=\"#cite_note-:2-3\">(3)<\/a><\/sup> Le patient doit \u00eatre interrog\u00e9 sur les points suivants :<\/p>\n<ul>\n<li>Facteurs pr\u00e9disposants (par exemple, le port de talons hauts)<\/li>\n<li>Activit\u00e9s et habitudes associ\u00e9es \u00e0 l&rsquo;affection (traumatismes li\u00e9s au sport, danseurs professionnels)<\/li>\n<li>Ant\u00e9c\u00e9dents de port d&rsquo;orth\u00e8ses<\/li>\n<\/ul>\n<h3><span id=\"Observation\/Palpation\"><\/span><span id=\"Observation.2FPalpation\" class=\"mw-headline\">Observation \/ Palpation<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Observation\/Palpation\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=8\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Observation\/Palpation\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=8\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>L&rsquo;observation doit \u00eatre compl\u00e9t\u00e9e avec le patient en position debout pour d\u00e9terminer la <i>direction du d\u00e9placement de la mise en charge<\/i>, la pr\u00e9sence d&rsquo;<i>anomalies ou de d\u00e9viations des petits orteils<\/i>, ou une <i>augmentation de l&rsquo;espace entre les orteils<\/i>. <sup id=\"cite_ref-:2_3-8\" class=\"reference\"><a href=\"#cite_note-:2-3\">(3)<\/a><\/sup> Ensuite, le clinicien doit observer pendant que le patient prend la position tenue sur une jambe. De plus, le patient peut signaler : <sup id=\"cite_ref-:4_12-2\" class=\"reference\"><a href=\"#cite_note-:4-12\">(12)<\/a><\/sup><\/p>\n<ul>\n<li>Des ant\u00e9c\u00e9dents de <i>douleur aigu\u00eb<\/i> dans les articulations MTP des quatre derniers orteils<\/li>\n<li>Une sensation de <i>gonflement local<\/i><\/li>\n<\/ul>\n<h3><span id=\"Tests\" class=\"mw-headline\">Tests<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Tests\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=9\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Tests\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=9\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<ul>\n<li>Un test de tiroir ant\u00e9ro-post\u00e9rieur positif ( <a title=\"Lachman Test\" href=\"\/Lachman_Test\">test de Lachman<\/a> modifi\u00e9). Le clinicien stabilise l&rsquo;orteil du patient au niveau du m\u00e9tatarse et exerce un test de tiroir sur les phalanges proximales. Un l\u00e9ger claquement peut \u00eatre entendu lorsque l&rsquo;articulation se subluxe en direction plantaire. Ce test est consid\u00e9r\u00e9 comme l&rsquo;outil le plus fiable et le plus pr\u00e9cis pour classifier une l\u00e9sion de la plaque plantaire. Thompson et Hamilton <sup id=\"cite_ref-15\" class=\"reference\"><a href=\"#cite_note-15\">(15)<\/a><\/sup> ont propos\u00e9 un syst\u00e8me de classification bas\u00e9 sur le niveau de subluxation de la phalange proximale : <sup id=\"cite_ref-:4_12-3\" class=\"reference\"><a href=\"#cite_note-:4-12\">(12)<\/a><\/sup>\n<ul>\n<li>G0 : articulation stable. La douleur est pr\u00e9sente, mais pas de d\u00e9formation de l&rsquo;articulation<\/li>\n<li>G1 : instabilit\u00e9 l\u00e9g\u00e8re (subluxation &lt; 50%) caract\u00e9ris\u00e9e par un \u00e9largissement de l&rsquo;espace entre les orteils et un d\u00e9placement m\u00e9dial. Douleur et oed\u00e8me articulaires<\/li>\n<li>G2 : instabilit\u00e9 mod\u00e9r\u00e9e (subluxation &gt; 50%) avec d\u00e9formation m\u00e9diale, lat\u00e9rale, dorsale ou dorsom\u00e9diale et hyperextension des orteils. Douleur articulaire avec peu ou pas d&rsquo;oed\u00e8me<\/li>\n<li>G3 : instabilit\u00e9 s\u00e9v\u00e8re (luxation articulaire possible) : d\u00e9formation dorsale ou dorsom\u00e9diale avec le deuxi\u00e8me orteil chevauchant l&rsquo;hallux. Une attitude en griffe flexible de l&rsquo;orteil peut \u00eatre pr\u00e9sente. Douleur articulaire et douleur au pied, peu ou pas d&rsquo;\u0153d\u00e8me<\/li>\n<li>G4 : articulation lux\u00e9e : d\u00e9formation grave et orteil en griffe fixe. Douleur articulaire et douleur au pied, peu ou pas d&rsquo;\u0153d\u00e8me<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Un plantar grip test ou test de \u00a0\u00bb tirage de papier \u00a0\u00bb n\u00e9gatif : ce test est \u00e9valu\u00e9 \u00e0 l&rsquo;aide d&rsquo;une bande de papier de 8 cm x 1 cm plac\u00e9e sous le 2e orteil du patient debout. Le patient est incapable de \u00ab\u00a0saisir\u00a0\u00bb le papier<\/li>\n<li>Un <a title=\"Windlass Test\" href=\"\/Windlass_Test\">test du guindeau<\/a> invers\u00e9 positif : Le patient est debout sur la petite bo\u00eete, les m\u00e9tatarses \u00e9tant appuy\u00e9s sur le bord de la bo\u00eete. Pas de pathologie : le m\u00e9canisme du guindeau assure une flexion plantaire de la phalange proximale sur le bord de la bo\u00eete. Pathologie : absence de flexion plantaire des orteils<\/li>\n<li>Un test manuel de force musculaire pour les muscles intrins\u00e8ques du pied et le long fl\u00e9chisseur des orteils (flexion plantaire des orteils)<\/li>\n<\/ul>\n<h2><span id=\"Management_\/_Interventions\"><\/span><span id=\"Management_.2F_Interventions\" class=\"mw-headline\">Traitement \/ Interventions <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Management \/ Interventions\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=10\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Management \/ Interventions\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=10\">modifier la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Le traitement conservateur d&rsquo;une l\u00e9sion de la plaque plantaire doit faire appel \u00e0 une approche holistique, qui aborde le type de chaussures port\u00e9es, le soutien local du pied, la force et la mobilit\u00e9 locales et globales (du pied et de la jambe), ainsi qu&rsquo;une \u00e9valuation de la posture.<\/p>\n<p><b>Le type de chaussures port\u00e9es <\/b>: ne pas marcher pieds nus, pas de talons hauts, pas de chaussures souples de type minimaliste, comme les chaussures \u00e0 bout ouvert ou les tongs. Nous recommandons plut\u00f4t une chaussure \u00e0 semelle rigide, une botte rigide ou une chaussure rocker (\u00e0 semelle berceau) avec une semelle int\u00e9rieure souple.<\/p>\n<p><b>Soutien local du pied :<\/b> il peut s&rsquo;agir d&rsquo;orth\u00e8ses personnalis\u00e9es, de tapings ou d&rsquo;\u00e9carteurs d&rsquo;orteils.<\/p>\n<ul>\n<li>Les orth\u00e8ses personnalis\u00e9es comportent g\u00e9n\u00e9ralement un coussinet m\u00e9tatarsien.<\/li>\n<\/ul>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/93\/Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg\/300px-Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/93\/Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg\/450px-Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/9\/93\/Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg\/600px-Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg 2x\" alt=\"\" width=\"300\" height=\"300\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Coussinet m\u00e9tatarsien<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<ul>\n<li>Les redresseurs et entretoises d&rsquo;orteils maintiennent les orteils \u00e9cart\u00e9s<\/li>\n<\/ul>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Toe_spacers_Shutterstock_Image_-_ID_1757915324.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/8\/83\/Toe_spacers_Shutterstock_Image_-_ID_1757915324.jpg\/300px-Toe_spacers_Shutterstock_Image_-_ID_1757915324.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/8\/83\/Toe_spacers_Shutterstock_Image_-_ID_1757915324.jpg\/450px-Toe_spacers_Shutterstock_Image_-_ID_1757915324.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/8\/83\/Toe_spacers_Shutterstock_Image_-_ID_1757915324.jpg\/600px-Toe_spacers_Shutterstock_Image_-_ID_1757915324.jpg 2x\" alt=\"\" width=\"300\" height=\"209\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Entretoises d&rsquo;orteil<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<ul>\n<li>Taping pour d\u00e9charger les t\u00eates m\u00e9tatarsiennes\n<ul>\n<li>Kin\u00e9siotaping : m\u00e9thode de la petite fourchette<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Kinesiotaping_for_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1762989269.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/d\/d8\/Kinesiotaping_for_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1762989269.jpg\/300px-Kinesiotaping_for_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1762989269.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/d\/d8\/Kinesiotaping_for_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1762989269.jpg\/450px-Kinesiotaping_for_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1762989269.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/d\/d8\/Kinesiotaping_for_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1762989269.jpg\/600px-Kinesiotaping_for_Plantar_Plate_Injury_-_Shutterstock_Image_-_ID_1762989269.jpg 2x\" alt=\"\" width=\"300\" height=\"450\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Kinesiotaping pour les l\u00e9sions de la plaque plantaire<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<ul>\n<li>Taping en ruban : bandes minces de tape adh\u00e9sif en tissu pos\u00e9s de fa\u00e7on \u00e0 limiter l&rsquo;extension au niveau de la deuxi\u00e8me MTP<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/meUFV2UQyf8?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-16\" class=\"reference\"><a href=\"#cite_note-16\">(16)<\/a><\/sup><\/p>\n<ul>\n<li><b>Force et mobilit\u00e9 locales et globales <\/b>: mobilisation du m\u00e9dio-pied, renforcement des muscles intrins\u00e8ques du pied et des fl\u00e9chisseurs plantaires des orteils, am\u00e9lioration du contr\u00f4le neuromusculaire au niveau du bassin et de la hanche. <sup id=\"cite_ref-17\" class=\"reference\"><a href=\"#cite_note-17\">(17)<\/a><\/sup><\/li>\n<\/ul>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Intrinsics_with_resistance.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/0\/0b\/Intrinsics_with_resistance.png\/300px-Intrinsics_with_resistance.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/0\/0b\/Intrinsics_with_resistance.png\/450px-Intrinsics_with_resistance.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/0\/0b\/Intrinsics_with_resistance.png\/600px-Intrinsics_with_resistance.png 2x\" alt=\"\" width=\"300\" height=\"149\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Exercices de renforcement des muscles intrins\u00e8ques du pied<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<h3><span id=\"Other_Interventions\" class=\"mw-headline\">Autres interventions <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Other Interventions\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=11\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Other Interventions\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=11\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<ul>\n<li>Th\u00e9rapie par ondes de choc <sup id=\"cite_ref-18\" class=\"reference\"><a href=\"#cite_note-18\">(18)<\/a><\/sup><\/li>\n<li>Injections de cortisone &#8211; attention : peut affaiblir la plaque plantaire<\/li>\n<li>Chirurgie &#8211; la chirurgie est complexe et le r\u00e9tablissement est lent<\/li>\n<\/ul>\n<h2><span id=\"Resources\" class=\"mw-headline\">Ressources<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Resources\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=12\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Resources\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=12\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<ol>\n<li><a title=\"Turf toe\" href=\"\/Turf_toe\">Turf toe<\/a><\/li>\n<li>Yamada AF, Crema MD, Nery C, Baumfeld D, Mann TS, Skaf AY, Fernandes ADRC. <a class=\"external text\" href=\"https:\/\/www.ajronline.org\/doi\/pdf\/10.2214\/AJR.16.17276\" rel=\"nofollow\">Second and Third Metatarsophalangeal Plantar Plate Tears: Diagnostic Performance of Direct and Indirect MRI Features Using Surgical Findings as the Reference Standard<\/a>. AJR Am J Roentgenol. 2017 Aug;209(2):W100-W108.<\/li>\n<li><a class=\"external text\" href=\"https:\/\/www.hmpgloballearningnetwork.com\/site\/podiatry\/understanding-biomechanics-plantar-plate-injuries\" rel=\"nofollow\">Understanding The Biomechanics Of Plantar Plate Injuries<\/a><\/li>\n<\/ol>\n<h2><span id=\"References\" class=\"mw-headline\">R\u00e9f\u00e9rences<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: References\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;veaction=edit&amp;section=13\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: References\" href=\"\/index.php?title=Plantar_Plate_Injuries&amp;action=edit&amp;section=13\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap mw-references-columns\">\n<ol class=\"references\">\n<li id=\"cite_note-:1-1\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:1_1-0\">1.0<\/a><\/sup> <sup><a href=\"#cite_ref-:1_1-1\">1.1<\/a><\/sup> <sup><a href=\"#cite_ref-:1_1-2\">1.2<\/a><\/sup> <sup><a href=\"#cite_ref-:1_1-3\">1.3<\/a><\/sup> <sup><a href=\"#cite_ref-:1_1-4\">1.4<\/a><\/sup> <sup><a href=\"#cite_ref-:1_1-5\">1.5<\/a><\/sup> <sup><a href=\"#cite_ref-:1_1-6\">1.6<\/a><\/sup> <sup><a href=\"#cite_ref-:1_1-7\">1.7<\/a><\/sup> <sup><a href=\"#cite_ref-:1_1-8\">1.8<\/a><\/sup> <sup><a href=\"#cite_ref-:1_1-9\">1.9<\/a><\/sup><\/span> <span class=\"reference-text\">Hallinan JTPD, Statum SM, Huang BK, Bezerra HG, Garcia DAL, Bydder GM, Chung CB. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7337226\/pdf\/rg.2020190145.pdf\" rel=\"nofollow\">High-Resolution MRI of the First Metatarsophalangeal Joint: Gross Anatomy and Injury Characterization<\/a>. Radiographics. 2020 Jul-Aug;40(4):1107-1124. <\/span><\/li>\n<li id=\"cite_note-:0-2\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:0_2-0\">2.0<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-1\">2.1<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-2\">2.2<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-3\">2.3<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-4\">2.4<\/a><\/sup> <sup><a href=\"#cite_ref-:0_2-5\">2.5<\/a><\/sup><\/span> <span class=\"reference-text\">Gyftopoulos S, Woertler K. Ankle and foot. Musculoskeletal Diseases 2021-2024. 2021:107-20.<\/span><\/li>\n<li id=\"cite_note-:2-3\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:2_3-0\">3.0<\/a><\/sup> <sup><a href=\"#cite_ref-:2_3-1\">3.1<\/a><\/sup> <sup><a href=\"#cite_ref-:2_3-2\">3.2<\/a><\/sup> <sup><a href=\"#cite_ref-:2_3-3\">3.3<\/a><\/sup> <sup><a href=\"#cite_ref-:2_3-4\">3.4<\/a><\/sup> <sup><a href=\"#cite_ref-:2_3-5\">3.5<\/a><\/sup> <sup><a href=\"#cite_ref-:2_3-6\">3.6<\/a><\/sup> <sup><a href=\"#cite_ref-:2_3-7\">3.7<\/a><\/sup> <sup><a href=\"#cite_ref-:2_3-8\">3.8<\/a><\/sup><\/span> <span class=\"reference-text\">Simpson H. Plantar Plate Injuries Course. Plus 2022<\/span><\/li>\n<li id=\"cite_note-4\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-4\">\u2191<\/a><\/span> <span class=\"reference-text\">Chen DW, Li B, Aubeeluck A, Yang YF, Huang YG, Zhou JQ, Yu GR. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3879302\/pdf\/pone.0084347.pdf\" rel=\"nofollow\">Anatomy and biomechanical properties of the plantar aponeurosis: a cadaveric study.<\/a> PLoS One. 2014 Jan 2;9(1):e84347.<\/span><\/li>\n<li id=\"cite_note-5\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-5\">\u2191<\/a><\/span> <span class=\"reference-text\">Finney FT, McPheters A, Singer NV, Scott JC, Jepsen KJ, Holmes JR, Talusan PG. Microvasculature of the Plantar Plate Using Nano\u2013Computed Tomography. Foot &amp; ankle international. 2019 Apr;40(4):457-64.<\/span><\/li>\n<li id=\"cite_note-6\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-6\">\u2191<\/a><\/span> <span class=\"reference-text\">Pelly T, Holme T, Tahir MA, Kunasingam K. Forefoot pain. BMJ. 2020 Oct 9;371.<\/span><\/li>\n<li id=\"cite_note-7\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-7\">\u2191<\/a><\/span> <span class=\"reference-text\">Lai SH, Tang CQ, Thevendran G. <a class=\"external text\" href=\"https:\/\/www.jfasap.com\/doi\/pdf\/10.5005\/jp-journals-10040-1124\" rel=\"nofollow\">Forefoot Injuries in Sports.<\/a> Journal of Foot and Ankle Surgery (Asia Pacific). 2020 Jul;7(2):51.<\/span><\/li>\n<li id=\"cite_note-:3-8\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:3_8-0\">8.0<\/a><\/sup> <sup><a href=\"#cite_ref-:3_8-1\">8.1<\/a><\/sup><\/span> <span class=\"reference-text\">Chen X, Zhou G, Xue H, Wang R, Bird S, Sun D, Cui L. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9322853\/pdf\/diagnostics-12-01541.pdf\" rel=\"nofollow\">High-Resolution Ultrasound of the Forefoot and Common Pathologies.<\/a> Diagnostics (Basel). 2022 Jun 24;12(7):1541. <\/span><\/li>\n<li id=\"cite_note-9\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-9\">\u2191<\/a><\/span> <span class=\"reference-text\">Klein EE, Weil L Jr, Weil LS Sr, Coughlin MJ, Knight J. Clinical examination of plantar plate abnormality: a diagnostic perspective. Foot Ankle Int. 2013 Jun;34(6):800-4.<\/span><\/li>\n<li id=\"cite_note-10\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-10\">\u2191<\/a><\/span> <span class=\"reference-text\">Feger J. Medial plantar nerve entrapment. Reference article, Radiopaedia.org. (accessed on 19 Oct 2022) <\/span><\/li>\n<li id=\"cite_note-11\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-11\">\u2191<\/a><\/span> <span class=\"reference-text\">Nery C, Coughlin MJ, Baumfeld D, Raduan FC, Mann TS, Catena F. Classification of metatarsophalangeal joint plantar plate injuries: history and physical examination variables. Journal of Surgical Orthopaedic Advances. 2014 Jan 1;23(4):214-23.<\/span><\/li>\n<li id=\"cite_note-:4-12\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:4_12-0\">12.0<\/a><\/sup> <sup><a href=\"#cite_ref-:4_12-1\">12.1<\/a><\/sup> <sup><a href=\"#cite_ref-:4_12-2\">12.2<\/a><\/sup> <sup><a href=\"#cite_ref-:4_12-3\">12.3<\/a><\/sup><\/span> <span class=\"reference-text\">Nery C, Coughlin M, Baumfeld D, Raduan F, Mann TS, Catena F. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4868080\/pdf\/main.pdf\" rel=\"nofollow\">How to classify plantar plate injuries: parameters from history and physical examination<\/a>. Rev Bras Ortop. 2015 Oct 26;50(6):720-8. <\/span><\/li>\n<li id=\"cite_note-13\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-13\">\u2191<\/a><\/span> <span class=\"reference-text\">Feuerstein CA, Weil L Jr, Weil LS Sr, Klein EE, Fleischer A, Argerakis NG. Static Versus Dynamic Musculoskeletal Ultrasound for Detection of Plantar Plate Pathology. Foot Ankle Spec. 2014 Aug 1;7(4):259-265.<\/span><\/li>\n<li id=\"cite_note-:5-14\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-:5_14-0\">\u2191<\/a><\/span> <span class=\"reference-text\">Albright RH, Brooks B, Chingre M, Klein EE, Weil Jr LS, Fleischer AE. Diagnostic accuracy of magnetic resonance imaging (MRI) versus dynamic ultrasound for plantar plate injuries: A systematic review and meta-analysis. European Journal of Radiology. 2022 Apr 30:110315.<\/span><\/li>\n<li id=\"cite_note-15\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-15\">\u2191<\/a><\/span> <span class=\"reference-text\">Thompson FM, Hamilton WG. Problems of the second metatarsophalangeal joint. Orthopaedics. 1987 Jan;10(1):83-9.<\/span><\/li>\n<li id=\"cite_note-16\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-16\">\u2191<\/a><\/span> <span class=\"reference-text\">Kevin Kirby. Plantarflexion Taping for Plantar Plate Tears. 2016. Available from: <a class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=meUFV2UQyf8\" rel=\"nofollow\">https:\/\/www.youtube.com\/watch?v=meUFV2UQyf8<\/a> (last accessed 10\/10\/2022)<\/span><\/li>\n<li id=\"cite_note-17\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-17\">\u2191<\/a><\/span> <span class=\"reference-text\">Ojofeitimi S, Bronner S, Becica L. <a class=\"external text\" href=\"https:\/\/www.jospt.org\/doi\/epdf\/10.2519\/jospt.2016.5824\" rel=\"nofollow\">Conservative management of second metatarsophalangeal joint instability in a professional dancer: a case report<\/a>. Journal of orthopaedic &amp; sports physical therapy. 2016 Feb;46(2):114-23.<\/span><\/li>\n<li id=\"cite_note-18\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-18\">\u2191<\/a><\/span> <span class=\"reference-text\">Labbad ZG, Love E, Shah DN, Kihira Y, Greensberg V. Treatment of lesser metatarsophalangeal joint plantar plate tear via Extracorporeal Pulse Activation Technology (EPAT) with MRI Follow-up: A case report. The Foot and Ankle Online Journal 2020; 13(2): 5. Available from <a class=\"external free\" href=\"http:\/\/faoj.org\/2020\/07\/31\/treatment-of-lesser-metatarsophalangeal-joint-plantar-plate-tear-via-extracorporeal-pulse-activation-technology-epat-with-mri-follow-up-a-case-report\/\" rel=\"nofollow\">http:\/\/faoj.org\/2020\/07\/31\/treatment-of-lesser-metatarsophalangeal-joint-plantar-plate-tear-via-extracorporeal-pulse-activation-technology-epat-with-mri-follow-up-a-case-report\/<\/a> (last access 10.10.2022)<\/span><\/li>\n<\/ol>\n<\/div>\n<p><!-- NewPP limit report Cached time: 20230118212646 Cache expiry: 0 Dynamic content: true Complications: () CPU time usage: 0.112 seconds Real time usage: 0.123 seconds Preprocessor visited node count: 408\/1000000 Post\u2010expand include size: 75\/2097152 bytes Template argument size: 0\/2097152 bytes Highest expansion depth: 3\/40 Expensive parser function count: 0\/100 Unstrip recursion depth: 0\/20 Unstrip post\u2010expand size: 12583\/5000000 bytes --><br \/>\n<!-- Transclusion expansion time report (%,ms,calls,template) 100.00% 9.125 1 Special:Contributors\/Plantar_Plate_Injuries 100.00% 9.125 1 -total --><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u00c9diteur original &#8211; Ewa Jaraczewska d&rsquo;apr\u00e8s le cours de Helene Simpson Principaux contributeurs &#8211; Ewa Jaraczewska et Jess Bell Contenu 1 Introduction 2 Anatomie cliniquement pertinente 3 M\u00e9canisme de la l\u00e9sion \/ Processus pathologique 4 Pr\u00e9sentation clinique 5 Proc\u00e9dures diagnostiques 6 \u00c9valuation 6.1 Entretien 6.2 Observation \/ Palpation 6.3 Tests 7 Traitement et Interventions 7.1 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-4686","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/4686","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/comments?post=4686"}],"version-history":[{"count":6,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/4686\/revisions"}],"predecessor-version":[{"id":5202,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/4686\/revisions\/5202"}],"wp:attachment":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/media?parent=4686"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}