Grégory Mesplié

Institut Sud Aquitain de la Main et du Membre Supérieur

Le carré pronateur fait partie de ces petits muscles dont on retient à peine l’anatomie et la physiologie. Et pourtant, l’auteur nous sensibilise sur ce muscle que le thérapeute aurait tort d’oublier.

La rééducation de la main nécessite une prise en charge spécifique et fait partie intégrante d’une équipe pluridisciplinaire permettant au patient d’être suivi efficacement de son traumatisme à la reprise de ses activités professionnelles et sportives. Cet ouvrage est le fruit de l’expérience de l’équipe de l’Institut Sud Aquitain de la Main et du...

Les évaluations clinique et fonctionnelle du poignet et de la main ont une importance fondamentale pour déterminer les origines histologiques des plaintes des patients présentant des pathologies à ce niveau. Elles nous permettent ainsi de mettre en place les traitements les plus adaptés et d'optimiser les résultats fonctionnels. Mots-clés : Examen...

Making an orthosis for a patient suffering from a hand injury is a fundamental step in their healing process, should it be aiming to immobilize or to rest injured tissues, or to optimize rehabilitation goals.

A peripheral nerve [2] is made of fascicles surrounded by connective tissue (the endoneurium) and contained in the perineurium. These fascicles are gathered in another tissue, the epineurium, which ensures the fixation and gliding of the nerve respective to the adjacent structures.

The etymology of the word “cryo” comes from the Greek “crio,” meaning “cold” or “frost.”

Proprioception is the ability to feel and perceive oneself [1] and helps maintaining joint homeostasis. This homeostasis is defined as a dynamic process in which the organism maintains and controls its environment despite external perturbations [2]. This ability, combined with a realized movement projection system, is essential for an adapted motor...

A methodological clinical assessment will provide all the clinical elements needed for clinical reasoning and will therefore lead to the most adapted therapeutic orientations.

In physiotherapy, the assessment is a clinical examination allowing to establish a treatment plan and to communicate with the rest of the healthcare team. It must be simple, repeatable, and compared to the healthy side (or to the standard). It must also be dated to assess the patient’s evolution.

This book developed from the experience of the ISAMMS team (Institut Sud Aquitain de la Main et du Membre Supérieur), that has been treating hand and wrist pathologies for over 20 years. Hand and wrist require specific care from a multidisciplinary staff. The patient has to be treated efficiently from injury in order to be able to return to work an...

La rééducation de la main nécessite une prise en charge spécifique et fait partie intégrante d’une équipe pluridisciplinaire permettant au patient d’être suivi efficacement de son traumatisme à la reprise de ses activités professionnelles et sportives. Cet ouvrage est le fruit de l’expérience de l’équipe de l’Institut Sud Aquitain de la Main et du...

Résumé Il existe plusieurs origines de la raideur au niveau de la main. La présence d’œdème, une rétraction au niveau cutané ou musculaire, une désorganisation du collagène ou un conflit osseux sont autant d’éléments qui peuvent mener à une perturbation du schéma moteur et une perte de mobilité. Il est important de les connaître et de savoir les di...

Résumé La prise en charge des patients traumatisés de la main est un challenge pour les rééducateurs car elle requiert des connaissances poussées d’anatomie, de biomécanique et de physiopathologie. L’examen clinique doit être méthodologique, et permettre de déterminer les techniques manuelles ou instrumentales les plus adaptées aux éléments retrouv...

Résumé Les instabilités scapho-lunaires sont des affections fréquentes et complexes qui nécessitent une bonne appréhension de la biomécanique du carpe. De récentes avancées ont permis de déterminer que la musculature du poignet joue un rôle fondamental dans cette stabilité, avec des muscles « protecteurs » de ce ligament, et d’autres « nocifs ». Si...

Distal radioulnar joint (DRUJ) instabilities are common and often combined with other injuries of the interosseous membrane and/or the proximal radioulnar joint. Once they are diagnosed and the treatment is chosen, physiotherapists have limited choices due to the lack of validated protocols. The benefits of proprioception and neuromuscular rehabili...

Fractures of the scaphoid are current, especially in young men, and represent 70–80 % of the traumas of the carpus. The large majority concerns the scaphoid waist, which is narrower and more fragile than the other parts of the bone. The injury is most often caused by a trauma in compression/shearing during the hyperextension of the wrist combined w...

The ulnar nerve is known to be vulnerable because of its anatomical path since the beginning of the twentieth century. A traumatic origin, or one secondary to a degenerative damage, was frequently found, and in 1957 Osborne described the concept of the cubital tunnel syndrome. He showed that opening this tunnel has positive effects on the symptomat...

Damages of the scapholunate ligament are the most frequent intracarpal ligamentous injuries. The injury mechanism is related to a trauma in hyperextension/radial inclination, often due to a fall on the thenar eminence. In these conditions, the scaphoid is under two opposed constraints, towards its extension because of the wrist extension and toward...

The radioulnar unity is a whole anatomical entity between the elbow and wrist [1] fatds It’s made of the two radioulnar joints and, a third part, the interosseous membrane [2] and the two bones of the forearm (see Chap. 1).

The complex regional pain syndrome (CRPS) is also known as algodystrophy, sympathetic neuroalgodystrophy, or reflex sympathetic dystrophy [1]. These numerous changes in the name show the “blur” that still surrounds this syndrome.

They are frequent in sports (ski, handball, basketball, rugby, etc.) and are mostly the result of valgus-dominant traumas in 90 % of the cases (damage of the medial collateral ligament). Varus-dominant traumas damage the lateral collateral ligament, and those in hyperextension damage the volar plate. Combined injuries of various elements are freque...

Joint stability is related to various anatomical elements, mainly: The collateral ligaments, spreading from the head of the 1st phalanx to the base of the 2nd phalanx, the volar plate and the flexor sheath. The principal fascicle is tensed between the head of the 1st phalanx and the base of the 2nd phalanx, with an insertion on the volar plate. The...

The Dupuytren disease is a pathology affecting the medium palmar aponeurosis and the digital aponeurosis, leading to the formation of cords and nodules. It can cause important retractions leading to flexion of the metacarpophalangeals, proximal interphalangeals, and more rarely distal interphalangeals. There are usually three stages of evolution: I...

The syndromes treated in this chapter are the carpal tunnel syndrome (without surgery or after surgery) and less frequent injuries like compression at the level of the arcade of Struthers, the lacertus fibrosus, between the two fascicles of the pronator teres, or under the flexor digiti superficialis. Rehabilitation of the entrapment syndromes of t...

The wrist is a joint complex essential in prehensions.

A huge progress has been made these last years in the surgical treatment and rehabilitation of the flexor system. However, a good knowledge of the tendon healing process and some experience are required to limit the risks of tears or secondary adherences. As always in hand surgery, but even more in tendon surgery, the gesture must be precise and me...

The extensor system is composed of an extrinsic system and an intrinsic system that work in synergy during the digital extension. It is extra-synovial, except at the level of the extensor retinaculum where it is surrounded by a synovial sheath allowing its lubrication and nutrition. The most frequent injuries are subcutaneous ruptures in zones 1, 2...

Fractures in the inferior extremity of the radius are related to a compression, from the carpus towards the forearm. It’s an extremely frequent trauma, especially in women with osteoporosis. There are two main types of fractures: Traumas in compression – extension, causing a dorsal displacement. For example, the Pouteau-Colles fractures, where we c...

Recent fractures of the scaphoid bone

The hand’s function is complex and depends on its architecture, which allows it to realize different prehensions. When grabbing voluminous objects, the hand describes various arches (transverse, longitudinal, and oblique), concave in the front, which give the hand the shape of a cup, facilitating the grips. When the hand is pressed against a suppor...

Compressions of the radial nerve are most frequent in the elbow and can cause two syndromes: The posterior interosseous nerve syndrome is the compression of the posterior interosseous nerve in the supinator arch. It causes a loss of extension in the wrist and fingers that worsens over time. The radial tunnel syndrome is a compression of the radial...

The hand is a wonderful prehension tool that relies on important sensorial and motor performances. An alteration of these performances can be related to different factors and must be very precisely treated, after evaluation of the disorders. At a sensorial level, when there are axonal injuries of the cutaneous nerves, the skin can present hypoesthe...