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Main traumatique de la personne âgée fragile

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Book cover Orthopédie-traumatologie de la personne âgée fragile

Part of the book series: Approche pratique en orthopédie - traumatologie ((APPRPRAT))

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Résumé

La fréquence des chutes, expliquée ailleurs dans cet ouvrage, associée à l’ostéoporose, explique la fréquence des lésions traumatiques chez la personne âgée [1]. Ces lésions présentent, de façon habituelle, des problèmes communs que sont:

  • • l’importance de la comminution et/ou du déplacement, liée à la fragilité osseuse

  • • la fragilité cutanée entraîne une fréquence plus élevée des lésions ouvertes. Du fait du faible risque infectieux à la main, ces lésions cutanées ne sont pas, de façon habituelle, un problème majeur. En revanche, la fragilité cutanée, parfois pathologique comme dans la dermatoporose, limite les possibilités chirurgicales, conduisant à des brochages, synthèse mécaniquement moins satisfaisante que des plaques, et obligeant à une immobilisation complémentaire;

  • • les difficultés sociales qu’entraîne une immobilisation; il faudra donc privilégier les techniques permettant une mobilisation immédiate, ce qui est, d’une part pas toujours possible à cause de la fragilité cutanée, d’autre part plus coûteux (matériel verrouillé);

  • • les difficultés de participation à la rééducation. Si un poignet raide n’est pas fonctionnellement gênant, une interphalangienne proximale raide fait perdre la fonction du doigt.

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Authors and Affiliations

  1. Service de Chirurgie Plastique, Reconstructrice et Esthétique, Chirurgie de la Main, Hôpital St Roch, 5 rue Pierre Devoluy, 06000, Nice, France

    C. Dumontier

  2. Service de chirurgie orthopédique, hôpital du Kremlin-Bicêtre, 78 rue du générale Leclerc, 94, Le Kremlin-Bicêtre, France

    M. Soubeyrand

  3. Service d’accueil et des urgences, hôpital Pierre Zobda Quitman, Route de Chateubeuf, 97200, Fort-de-france, France

    S. Carmès

Authors
  1. C. Dumontier
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  2. M. Soubeyrand
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  3. S. Carmès
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Correspondence to C. Dumontier .

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Sylvain Terver Frédéric Martins-Condé Bernard Leblanc

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Dumontier, C., Soubeyrand, M., Carmès, S. (2013). Main traumatique de la personne âgée fragile. In: Terver, S., Martins-Condé, F., Leblanc, B. (eds) Orthopédie-traumatologie de la personne âgée fragile. Approche pratique en orthopédie - traumatologie. Springer, Paris. https://doi.org/10.1007/978-2-8178-0377-7_19

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  • DOI: https://doi.org/10.1007/978-2-8178-0377-7_19

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0376-0

  • Online ISBN: 978-2-8178-0377-7

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