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Extra info for La cheville traumatique: des certitudes en traumatologie du sport
Sample text
Dans les évolutions normales, la continuité du ligament se restaure (figure 20), sa tension réapparaît progressivement ; il devient continu, normotendu, puis la composante hypoéchogène périligamentaire disparaît. À la phase séquellaire, non douloureuse, on repère un antécédent de lésion à l’aspect du ligament : il est un peu plus épais, souvent plus échogène, il a perdu sa structure fibrillaire et présente des versants discrètement irréguliers [2,10,24] (figure 21). Figure 20. Cicatrisation ligamentaire ; le défect se comble, restaurant la continuité ligamentaire mais l’œdème hypoéchogène est encore décelé, la cicatrisation est donc encore active.
Epidemiology of sprains of the lateral ankle ligament complex. Foot Ankle Clin 2006 ; 11 : 659-62. 5 Frey A, Boulet N, Simon N, Coudert X. Évaluation en urgence In : Rodineau J, Saillant G, eds. Les lésions ligamentaires récentes du cou-de-pied. Paris : Masson ; 1996. p. 79-88. 6 Borne J, Fontino O, Chevrot A. Les ligaments collatéraux de la cheville In : Rodineau J, Saillant G, eds. La lésion ligamentaire périphérique récente. Paris : Masson ; 2003. p. 187-202. 7 Watin Augouard L, Kouvalchouk JF.
L’échographie étudie les ligaments des 4 articulations de la cheville et de l’arrière-pied en vérifiant la tension de chaque ligament comparativement au côté opposé. Elle recherche, pour chaque faisceau, une rupture, une désinsertion ou un épaississement ecchymotique, mais aussi un arrachement osseux, et dépiste une luxation des tendons fibulaires et tibial postérieur. Il ne faut jamais négliger ces principes pour ne pas, par incompétence, pénaliser cette technique dont les performances sont grandes et souvent sous-évaluées.