{"id":611,"date":"2022-03-14T19:05:39","date_gmt":"2022-03-14T19:05:39","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/case-study-upper-limb-peripheral-nerve-injury-in-disasters-and-conflicts-fr\/"},"modified":"2022-05-02T04:47:42","modified_gmt":"2022-05-02T04:47:42","slug":"case-study-upper-limb-peripheral-nerve-injury-in-disasters-and-conflicts-fr","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/fr\/case-study-upper-limb-peripheral-nerve-injury-in-disasters-and-conflicts-fr\/","title":{"rendered":"\u00c9tude de cas &#8211; L\u00e9sion d&rsquo;un nerf p\u00e9riph\u00e9rique du membre sup\u00e9rieur en situation de catastrophe ou de conflit"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\">\n<p><b>R\u00e9dacteurs originaux <\/b> &#8211; <a class=\"new\" title=\"User:Naomi O Reilly (page does not exist)\" href=\"\/index.php?title=User:Naomi_O_Reilly&amp;action=edit&amp;redlink=1\">Naomi O Reilly<\/a><\/p>\n<p><b>Principaux contributeurs<\/b> &#8211; <a class=\"mw-userlink\" title=\"User:Naomi O'Reilly\" href=\"\/User:Naomi_O%27Reilly\"><bdi>Naomi O&rsquo;Reilly<\/bdi><\/a> et <a class=\"mw-userlink\" title=\"User:Olajumoke Ogunleye\" href=\"\/User:Olajumoke_Ogunleye\"><bdi>Olajumoke Ogunleye<\/bdi><\/a><\/p>\n<\/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=\"#Title\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">Titre<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-2\"><a href=\"#Abstract\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">R\u00e9sum\u00e9<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-3\"><a href=\"#Key_Words\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">Mots cl\u00e9s <\/span> <\/a><\/li>\n<li class=\"toclevel-1 tocsection-4\"><a href=\"#Patient_Characteristics\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">Caract\u00e9ristiques des patients<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-5\"><a href=\"#Background\"><span class=\"tocnumber\">4.1<\/span> <span class=\"toctext\">Contexte<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-6\"><a href=\"#Subjective_Assessment\"><span class=\"tocnumber\">4.2<\/span> <span class=\"toctext\">\u00c9valuation subjective<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-7\"><a href=\"#Social_History\"><span class=\"tocnumber\">4.3<\/span> <span class=\"toctext\">Histoire sociale<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-8\"><a href=\"#Past_Medical_History\"><span class=\"tocnumber\">4.4<\/span> <span class=\"toctext\">Ant\u00e9c\u00e9dents m\u00e9dicaux<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-9\"><a href=\"#Presenting_Condition\"><span class=\"tocnumber\">4.5<\/span> <span class=\"toctext\">\u00c9tat actuel<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-10\"><a href=\"#Examination_Findings\"><span class=\"tocnumber\">5<\/span> <span class=\"toctext\">R\u00e9sultats d&rsquo;examen<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-11\"><a href=\"#Observation\"><span class=\"tocnumber\">5.1<\/span> <span class=\"toctext\">Observation<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-12\"><a href=\"#Sensation\"><span class=\"tocnumber\">5.2<\/span> <span class=\"toctext\"><b>Sensations<\/b><\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-13\"><a href=\"#Passive_Movement\"><span class=\"tocnumber\">5.3<\/span> <span class=\"toctext\"><b>Mouvement passif<\/b><\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-14\"><a href=\"#Functional_Assessment\"><span class=\"tocnumber\">5.4<\/span> <span class=\"toctext\"><b>\u00c9valuation fonctionnelle<\/b><\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-15\"><a href=\"#Clinical_Impression\"><span class=\"tocnumber\">6<\/span> <span class=\"toctext\">Impression clinique<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-16\"><a href=\"#Treatment\"><span class=\"tocnumber\">7<\/span> <span class=\"toctext\">Traitement<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-17\"><a href=\"#Goals\"><span class=\"tocnumber\">7.1<\/span> <span class=\"toctext\"><b>Objectifs<\/b><\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-18\"><a href=\"#Short-term\"><span class=\"tocnumber\">7.1.1<\/span> <span class=\"toctext\"><b>\u00c0 court terme<\/b><\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-19\"><a href=\"#Long-term\"><span class=\"tocnumber\">7.1.2<\/span> <span class=\"toctext\"><b>\u00c0 long terme<\/b><\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-2 tocsection-20\"><a href=\"#Approach\"><span class=\"tocnumber\">7.2<\/span> <span class=\"toctext\">Approche<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-21\"><a href=\"#Education\"><span class=\"tocnumber\">7.3<\/span> <span class=\"toctext\"><b>\u00c9ducation<\/b><\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-22\"><a href=\"#Outcome\"><span class=\"tocnumber\">8<\/span> <span class=\"toctext\">R\u00e9sultats<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-23\"><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=\"Title\" class=\"mw-headline\">Titre<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Title\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=1\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Title\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=1\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<p>Fracture multi-fragmentaire, ouverte, de la mi-diaphyse de I&rsquo;hum\u00e9rus, trait\u00e9e avec fixation externe. L\u00e9sion pr\u00e9sum\u00e9e du nerf radial potentiellement subie au moment de la blessure initiale ou en cours d&rsquo;op\u00e9ration <sup id=\"cite_ref-1\" class=\"reference\"><a href=\"#cite_note-1\">[1]<\/a><\/sup><\/p>\n<p>Merci \u00e0 Humanit\u00e9 et Inclusion pour cette<a class=\"external text\" href=\"https:\/\/resources.relabhs.org\/resource\/early-rehabilitation-in-conflicts-and-disasters\/\" rel=\"nofollow\">\u00e9tude de cas tir\u00e9e de R\u00e9adaptation pr\u00e9coce en situations de conflit et de catastrophe &#8211; Manuel clinique<\/a><\/p>\n<h2><span id=\"Abstract\" class=\"mw-headline\">R\u00e9sum\u00e9<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Abstract\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=2\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Abstract\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=2\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<p>Mahmoud est un homme de 26 ans qui a subi une blessure p\u00e9n\u00e9trante \u00e0 l&rsquo;arri\u00e8re de son bras droit lorsqu&rsquo;il a \u00e9t\u00e9 heurt\u00e9 par un morceau de toiture m\u00e9tallique au cours de vents violents lors d&rsquo;un cyclone il y a 10 jours, entra\u00eenant une fracture ouverte multi-fragmentaire de l&rsquo;hum\u00e9rus au centre de la diaphyse qui a n\u00e9cessit\u00e9 une fixation externe. On soupsonne maintenant une l\u00e9sion du nerf radial neurotm\u00e9sique survenue soit au moment de la blessure initiale, soit en cours d&rsquo;op\u00e9ration.<\/p>\n<h2><span id=\"Key_Words\" class=\"mw-headline\">Mots cl\u00e9s <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Key Words\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=3\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Key Words\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=3\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<p>Fracture ouverte, l\u00e9sion du nerf p\u00e9riph\u00e9rique, nerf radial, neurotm\u00e8se<\/p>\n<h2><span id=\"Patient_Characteristics\" class=\"mw-headline\">Caract\u00e9ristiques des patients<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Patient Characteristics\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=4\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Patient Characteristics\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=4\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<h3><span id=\"Background\" class=\"mw-headline\">contexte<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Background\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=5\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Background\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=5\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>Il y a dix jours, Mahmoud, 26 ans, a subi une blessure p\u00e9n\u00e9trante \u00e0 l&rsquo;arri\u00e8re de son bras droit lorsqu&rsquo;il a \u00e9t\u00e9 frapp\u00e9 par un morceau de toiture m\u00e9tallique pendant le cyclone qui a frapp\u00e9 sa communaut\u00e9 insulaire. Il a pu acc\u00e9der \u00e0 un premier traitement m\u00e9dical \u00e0 l&rsquo;h\u00f4pital central o\u00f9 la plaie a \u00e9t\u00e9 nettoy\u00e9e et une fixation externe a \u00e9t\u00e9 appliqu\u00e9e pour stabiliser une fracture multi-fragmentaire de l&rsquo;hum\u00e9rus m\u00e9dian. Comme il \u00e9tait par ailleurs m\u00e9dicalement stable, on l&rsquo;a lib\u00e9r\u00e9 en lui demandant de se pr\u00e9senter en r\u00e9adaptation comme patient externe la semaine suivante, pour une \u00e9valuation de la plaie et une r\u00e9adaptation.<\/p>\n<h3><span id=\"Subjective_Assessment\" class=\"mw-headline\">\u00c9valuation subjective<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Subjective Assessment\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=6\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Subjective Assessment\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=6\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>L&rsquo;\u00e9valuation subjective est difficile, car Mahmoud souffre \u00e9norm\u00e9ment et est angoiss\u00e9 de n&rsquo;avoir pu localiser sa femme ou ses deux enfants depuis le cyclone.<\/p>\n<h3><span id=\"Social_History\" class=\"mw-headline\">Histoire sociale<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Social History\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=7\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Social History\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=7\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>Il vit actuellement dans un abri temporaire mis en place par une ONG internationale et se rend seul \u00e0 la clinique. Avant le cyclone, il faisait vivre sa petite famille en assurant un service de taxi dans la r\u00e9gion.<\/p>\n<h3><span id=\"Past_Medical_History\" class=\"mw-headline\">Ant\u00e9c\u00e9dents m\u00e9dicaux<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Past Medical History\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=8\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Past Medical History\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=8\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>Mahmoud est droitier et n&rsquo;a pas d&rsquo;ant\u00e9c\u00e9dents m\u00e9dicaux ni de probl\u00e8mes de mobilit\u00e9.<\/p>\n<h3><span id=\"Presenting_Condition\" class=\"mw-headline\">\u00c9tat actuel<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Presenting Condition\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=9\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Presenting Condition\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=9\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>Mahmoud rapporte une douleur intense (VAS 10\/10) le long du dos de son bras, associ\u00e9e \u00e0 un engourdissement sur le dessus de sa main, autour de la zone du pouce. La douleur est particuli\u00e8rement forte la nuit et il \u00e9prouve des difficult\u00e9s \u00e0 dormir.<\/p>\n<p>Depuis sa blessure, il a \u00e9prouv\u00e9 des difficult\u00e9s \u00e0 bouger le bras droit mais rapporte que, depuis l&rsquo;op\u00e9ration, il s&rsquo;agit d&rsquo;un ph\u00e9nom\u00e8ne plus isol\u00e9, qui se limite \u00e0 l&rsquo;extension du poignet et des doigts. Bien que ce soit difficile, Mahmoud rapporte qu&rsquo;il n&rsquo;utilise que son bras gauche car il s&rsquo;inqui\u00e8te des sympt\u00f4mes et pense que quelque chose a mal tourn\u00e9 avec son bras droit.<\/p>\n<h2><span id=\"Examination_Findings\" class=\"mw-headline\">R\u00e9sultats de l&rsquo;examen<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Examination Findings\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=10\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Examination Findings\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=10\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<h3><span id=\"Observation\" class=\"mw-headline\">Observations<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Observation\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=11\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Observation\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=11\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>Le patient est assis avec le bras droit soutenu par le gauche en travers de son corps (posture de protection). Fixation externe \u00e0 l&rsquo;hum\u00e9rus droit avec des sites de broches propres et une plaie cicatris\u00e9e sans aucun signe d&rsquo;infection. L\u00e9ger gonflement de la main droite, mais temp\u00e9rature et couleur de la peau normales dans tout le bras droit.<\/p>\n<h3><span id=\"Sensation\" class=\"mw-headline\"><b>Sensation<\/b><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Sensation\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=12\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Sensation\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=12\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>Perte totale de la sensation \u00e0 la partie sup\u00e9rieure du pouce droit. Toutes les autres zones sont sensibles mais pr\u00e9sentent une hyperalg\u00e9sie.<\/p>\n<h3><span id=\"Sensation\" class=\"mw-headline\"><b>Mouvement actif<\/b><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Sensation\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=12\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Sensation\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=12\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>Mouvements du cou et du membre sup\u00e9rieur gauche non affect\u00e9 complets.<\/p>\n<p>Mouvements de l&rsquo;\u00e9paule droite limit\u00e9s par la raideur et la douleur mais fonction motrice intacte.<\/p>\n<ul>\n<li>L&rsquo;extension du coude, la supination de l&rsquo;avant-bras, l&rsquo;extension du poignet, l&rsquo;extension des doigts et du pouce sont \u00e0 M0.<\/li>\n<li>Tous les autres muscles du membre sup\u00e9rieur droit sont cot\u00e9s M4 et limit\u00e9s par la douleur.<\/li>\n<\/ul>\n<h3><span id=\"Passive_Movement\" class=\"mw-headline\"><b>Mouvement passif<\/b><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Passive Movement\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=13\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Passive Movement\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=13\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>Raideur en fin de ROM \u00e0 l&rsquo;extension du coude, du poignet, des doigts et du pouce<\/p>\n<h3><span id=\"Functional_Assessment\" class=\"mw-headline\"><b>\u00c9valuation fonctionnelle<\/b><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Functional Assessment\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=14\">edit<\/a> <span class=\"mw-editsection-divider\">|<\/span> <a title=\"Edit section: Functional Assessment\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=14\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>Incapacit\u00e9 \u00e0 positionner la main droite pour saisir tout objet avec pression<\/p>\n<h2><span id=\"Clinical_Impression\" class=\"mw-headline\">Impression clinique<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinical Impression\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=15\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Clinical Impression\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=15\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<p>Patient de 26 ans, droitier, souffrant d&rsquo;une fracture multi-fragmentaire ouverte de l&rsquo;hum\u00e9rus m\u00e9dian droit, trait\u00e9e avec fixation externe. L\u00e9sion pr\u00e9sum\u00e9e du nerf radial droit, potentiellement subie au moment de la blessure initiale ou en cours d&rsquo;op\u00e9ration. Neurotm\u00e8se suspect\u00e9e en raison de la localisation et du m\u00e9canisme de la blessure, l&rsquo;engourdissement total et la perte de motricit\u00e9 dans la distribution du nerf radial.<\/p>\n<p>Niveaux de douleur \u00e9lev\u00e9s limitant les options de r\u00e9adaptation actuelles et susceptibles d&rsquo;avoir un impact significatif sur la fonction et la sant\u00e9 mentale. Absence d&rsquo;extension active du poignet, des doigts et du pouce limitant la capacit\u00e9 \u00e0 positionner la main pour saisir des objets, malgr\u00e9 la capacit\u00e9 \u00e0 fl\u00e9chir les doigts. Risque important de contracture articulaire secondaire, d&rsquo;allodynie et de r\u00e9duction de la fonction \u00e0 long terme.<\/p>\n<h2><span id=\"Treatment\" class=\"mw-headline\">Traitement<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Treatment\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=16\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Treatment\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=16\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<h3><span id=\"Goals\" class=\"mw-headline\"><b>Objectifs<\/b><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Goals\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=17\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Goals\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=17\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<h4><span id=\"Short-term\" class=\"mw-headline\"><b>\u00c0 court terme<\/b><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Short-term\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=18\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Short-term\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=18\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h4>\n<p>Diminuer et g\u00e9rer la douleur de mani\u00e8re ad\u00e9quate pour favoriser le sommeil, am\u00e9liorer la capacit\u00e9 \u00e0 \u00e9valuer le patient avec pr\u00e9cision et am\u00e9liorer la capacit\u00e9 du patient \u00e0 suivre un plan de traitement. Am\u00e9liorer la compr\u00e9hension par le patient de la fonction des nerfs p\u00e9riph\u00e9riques et des raisons pour lesquelles il \u00e9prouve ses sympt\u00f4mes actuels afin d&rsquo;am\u00e9liorer sa confiance et de lui permettre de participer \u00e0 sa r\u00e9adaptation sans craindre de cr\u00e9er de nouveaux dommages. Sensibiliser le patient aux cons\u00e9quences de la perte de sensation du dos de la main sur le plan de la s\u00e9curit\u00e9. Retrouver un ROM passif complet \u00e0 toutes les articulations du bras droit. Fournir une attelle pour am\u00e9liorer la position du poignet et permettre une pr\u00e9hension fonctionnelle. Encourager le patient \u00e0 utiliser la main\/le bras droit sans craindre de se blesser. Organiser une r\u00e9\u00e9valuation dans les six semaines \u00e0 venir pour examiner tout signe de r\u00e9cup\u00e9ration du nerf radial, c&rsquo;est-\u00e0-dire s&rsquo;il y a neuropraxie ou neurotm\u00e8se.<\/p>\n<h4><span id=\"Long-term\" class=\"mw-headline\"><b>\u00c0 long terme<\/b><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Long-term\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=19\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Long-term\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=19\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h4>\n<p>R\u00e9soudre ou g\u00e9rer efficacement la douleur nerveuse si cette douleur persiste. Pr\u00e9venir les contractures de flexion au niveau du coude, du poignet, des doigts et du pouce afin de maintenir toute fonction et d&rsquo;am\u00e9liorer le r\u00e9sultat si une chirurgie secondaire est disponible dans les deux ann\u00e9es \u00e0 venir, comme on soup\u00e7onne la neurotm\u00e8se. Maintenir l&rsquo;attelle pour aider \u00e0 la fonction.<\/p>\n<h3><span id=\"Approach\" class=\"mw-headline\">Approche<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Approach\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=20\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Approach\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=20\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>Conseils sur le positionnement pour le confort avec le bras soutenu et la main sur\u00e9lev\u00e9e pour r\u00e9duire le risque de gonflement. Le patient ne doit pas maintenir cette position de protection pendant de longues p\u00e9riodes, car il existe un risque de contracture en flexion.<\/p>\n<p>Conseil de prendre les m\u00e9dicaments contre la douleur nerveuse tels que prescrits, afin d&rsquo;am\u00e9liorer la capacit\u00e9 \u00e0 dormir, \u00e0 g\u00e9rer la r\u00e9adaptation et \u00e0 utiliser sa main et son bras.<\/p>\n<p>Techniques de d\u00e9sensibilisation, une fois que les m\u00e9dicaments contre la douleur nerveuse ont commenc\u00e9 \u00e0 agir.<\/p>\n<p>Attelle d&rsquo;extension du poignet avec conseil de l&rsquo;enlever r\u00e9guli\u00e8rement pour \u00e9viter la perte de flexion du poignet.<\/p>\n<p>ROM et force : Enseigner les prises fonctionnelles avec l&rsquo;attelle et encourager l&rsquo;utilisation du bras droit.<\/p>\n<p>Exercices de ROM passif et actif pour traiter la raideur initiale, pr\u00e9venir la contracture et renforcer les muscles non affect\u00e9s. Faire le lien avec l&rsquo;\u00e9quipe m\u00e9dicale pour communiquer tout signe de l\u00e9sion du nerf radial.<\/p>\n<p>\u00c9tablir des plans pour les d\u00e9lais de retrait de la fixation externe.<\/p>\n<h3><span id=\"Education\" class=\"mw-headline\"><b>\u00c9ducation<\/b><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Education\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=21\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Education\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=21\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>Explication de la l\u00e9sion du nerf radial et de la douleur nerveuse, le patient n&rsquo;\u00e9tant conscient que de la fracture. La r\u00e9\u00e9valuation dans 6-8 semaines est importante pour d\u00e9terminer si neuropraxie ou neurotm\u00e8se, mais le patient doit \u00eatre conscient que les risques de l\u00e9sions \u00e0 long terme sont \u00e9lev\u00e9s. L&rsquo;acc\u00e8s aux m\u00e9dicaments contre la douleur nerveuse est extr\u00eamement important pour g\u00e9rer le sommeil et la capacit\u00e9 \u00e0 se conformer \u00e0 la r\u00e9adaptation. Ce m\u00e9dicament peut ne pas agir imm\u00e9diatement, mais ses effets s&rsquo;accumulent au fil du temps.<\/p>\n<p>Retrouver un mouvement passif et pr\u00e9venir la contracture de flexion au coude, au poignet, aux doigts et au pouce. Le maintien du ROM complet et de la force des muscles non affect\u00e9s ne causera aucun dommage. Utilisation d&rsquo;une attelle de poignet pour aider \u00e0 la fonction et aider \u00e0 pr\u00e9venir la contracture. Conseils concernant le retrait r\u00e9gulier de l&rsquo;attelle pour surveiller les zones de pression (en particulier \u00e0 la base engourdie du pouce) et pour permettre une flexion active compl\u00e8te du poignet. Continuer les exercices au moins trois fois par jour.<\/p>\n<h2><span id=\"Outcome\" class=\"mw-headline\">R\u00e9sultats<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Outcome\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=22\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Outcome\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=22\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<p>Apr\u00e8s la s\u00e9ance de r\u00e9adaptation, Mahmoud comprend les deux parties de sa blessure ; la fracture hum\u00e9rale et la l\u00e9sion du nerf radial. Il comprend la douleur nerveuse qu&rsquo;il \u00e9prouve et a un plan pour s&rsquo;approvisionner en m\u00e9dicaments sp\u00e9cifiques contre la douleur nerveuse avec l&rsquo;\u00e9quipe m\u00e9dicale. Mahmoud travaillera lui-m\u00eame sur son ROM, maintenant qu&rsquo;il ne craint plus de causer davantage de dommages et qu&rsquo;il veut \u00e9viter toute autre complication. Il est capable de mettre lui-m\u00eame son attelle de poignet et peut constater qu&rsquo;il est maintenant capable de former un poing et de saisir des objets. Il comprend qu&rsquo;il doit retourner \u00e0 la clinique pour une autre \u00e9valuation afin de voir si son nerf montre des signes de r\u00e9cup\u00e9ration, mais il est conscient qu&rsquo;il y a de fortes chances qu&rsquo;\u00e0 long terme il soit incapable d&rsquo;\u00e9tendre activement son coude, son poignet, ses doigts et son pouce.<\/p>\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=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=23\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: References\" href=\"\/index.php?title=Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts&amp;action=edit&amp;section=23\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap\">\n<ol class=\"references\">\n<li id=\"cite_note-1\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-1\">\u2191<\/a><\/span> <span class=\"reference-text\">Lathia C, Skelton P, Clift Z. Early Rehabilitation in Conflicts and Disasters. Handicap International: London, UK. 2020.<\/span><\/li>\n<\/ol>\n<\/div>\n<p><!-- NewPP limit report Cached time: 20220308124639 Cache expiry: 0 Dynamic content: true Complications: [] CPU time usage: 0.038 seconds Real time usage: 0.042 seconds Preprocessor visited node count: 96\/1000000 Post\u2010expand include size: 100\/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: 642\/5000000 bytes --><br \/>\n<!-- Transclusion expansion time report (%,ms,calls,template) 100.00% 13.549 1 Special:Contributors\/Case_Study_-_Upper_Limb_Peripheral_Nerve_Injury_in_Disasters_and_Conflicts 100.00% 13.549 1 -total --><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>R\u00e9dacteurs originaux &#8211; Naomi O Reilly Principaux contributeurs &#8211; Naomi O&rsquo;Reilly et Olajumoke Ogunleye Contenu 1 Titre 2 R\u00e9sum\u00e9 3 Mots cl\u00e9s 4 Caract\u00e9ristiques des patients 4.1 Contexte 4.2 \u00c9valuation subjective 4.3 Histoire sociale 4.4 Ant\u00e9c\u00e9dents m\u00e9dicaux 4.5 \u00c9tat actuel 5 R\u00e9sultats d&rsquo;examen 5.1 Observation 5.2 Sensations 5.3 Mouvement passif 5.4 \u00c9valuation fonctionnelle 6 Impression [&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-611","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/611","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=611"}],"version-history":[{"count":2,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/611\/revisions"}],"predecessor-version":[{"id":736,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/611\/revisions\/736"}],"wp:attachment":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/media?parent=611"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}