infections main poignet 2015 2016

8/20/2019 Infections Main Poignet 2015 2016

1/52

Hnbdethfns prfbfnlds ï`j gjhn dt ju pfhindt

@ds dspjeds ld lhbbushfnEcrhsthjn Lugfnthdr, Edntrd ld `j Gjhn, Iujld`fupd

Utdbjnhj Arundtth, Dtulhjntd LHT 1?:5-1?:4


2/52

@ds hnbdethfns prfbfnlds ld `j gjhn

Jssdz rjrds GJHUpftdnthd``dgdnt irjvds( sèqud``ds bfnethfnnd``ds,jgputjthfn, lèeãs,…)

9% ld lèeãs sur hnbdethfns ld`j gjhn jvjnt `ds jnthahfthquds

4-:4% lds hnbdethfns ld `j gjhn(Mdasfn :883), musqu‘ï 99%

GeKhg @C. Hnbdethfns fb tcd Cjnl . Ejn Gdl Jssfe M. :813 Mjn;:3(:)=:9-11.

\ðrkdr \, Cjnl hnbdethfns= j rdtrfspdethvd jnj`yshs. _ddrM. 1?:< Udp 1;1=d4:5.Dvidnhfu D:, Hydr U. _yfidnhe b`dxfr tdnfsynfvhths `djlhni tf jn jgputjthfn. AGM Ejsd Qdp. 1?:1 Jui 1


3/52

_fur ahdn prdnlrd dn ecjrid und

hnbdethfn prfbfnld ld `j gjhn

Efnnjhssjneds lds prhnehpds iènèrjux

Efnnjhssjned lu pjthdnt dt ld sds ef-gfrahlhtès

EFNNJHUUJNED LD @‘JNJ\FGHD LDUDU_JEDU JNJ\FGHZTDU +++


4/52

@‘èef`d ld Echejif jvde `ds Lrs.J`jn Kjnjvd`, Uugndr Kfec,

Ghecjd` Gjsfn, dt Cjrvdy J``dnsfnt lds bfnljtdurs ld `j

echrurihd ld `j gjhn gfldrnd dt`durs trjvjux sur `ds hnbdethfns

ld `j gjhn rdstdnt und rèbèrdned

Kjnjvd` J``dn A. Jn jnjtfghej`, dxpdrhgdntj`, jnl e`hnhej` stuly fb jeutd pc`digfns fb tcd cjnl Z Au`` Nfrtcwdst Tnhv GdlUec. :8?2 Gjrec; 9(


5/52

Ljns edt fuvrjid,dn pjrthd lhspfnha`d sur iffi`d,Kjnjvd` lèerht `ds

dspjeds ldlhbbushfn lds

hnbdethfns ï `j gjhn

dt ju pfhindt, dtefggdnt `dslrjhndr

dbejedgdnt

Qjrds


6/52

Dspjeds jnjtfghquds

_rfbfnls, ahdn

lè`hghtès

5 dspjeds ï `j gjhn=\cdnjr, gdlhf-pj`gjhrddt cypftcdnjr

: dspjed ï `‘jvjnt-arjs(dspjed ld _jrfnj)

Ijhnds u`njhrd dt rjlhj`d(dt lhihtj`ds)

Uupdrehd`s, gj`

`hghtès

Lfrsj` (sus fu sfus-jpfnèvrfthqud)

Hntdrlhihtj` fu

efgghssurj`


7/52

Hnbdethfns ld `‘dspjed

lfrsj`(supdrehd`, gj` `hghtè)


8/52

Lfs ld `j gjhn

Ldux dspjeds= sus dt sfus `dstdnlfns

]fnd ld lhbbushfn sjns afrlurds fdlãgd lhbbus, i`faj`, pjrbfhs

pdu/pjs ld pus gjhs irfslèef``dgdnt

Lhbeh`d ï lhbbèrdnehdr l‘unded``u`htd (pfnethfn, èecf,…)

Lrjhnjid lhbeh`d / brustrjnt


9/52

Lfs ld `j gjhn

Dxehshfn ld `j pfrtdl‘dntrèd

_fur s‘jirjnlhr= Lduxhnehshfns afrl rjlhj` ld`‘hnldx dt 4ãgd gètj(nd pjs dxpfsdr `dstdnlfns)

_js ld `jgd (dntrdthdn`‘hnbdethfn)

J èvhtdr !


10/52Hnbdethfn supdrehd``d lfs ld `j gjhn (afutfn irjttè)


11/52

Hnbdethfn prfbfnld lu lfs ld`j gjhn (efggdnt s‘jirjnlhr)


12/52

Hnbdethfns lds dspjedshntdrlhihtjux

(Uupdrehd`, gj` `hghtè)


13/52

Efgghssurds

Jnjtfghd efgp`dxd,erfhsdgdnt ldspèlheu`ds, lds`fgarhejux dt ldsstrueturds ardusds

Dn jvjnt= ̀ hijgdntnjtjtfhrd (lhstj`) dt`hijgdnt pj`gjhrdtrjnsvdrsd (prfxhgj`)


14/52

@hijgdnt pj`gjhrdtrjnsvdrsd (Ukffi)


15/52

@hijgdnt njtjtfhrd


16/52

Efgghssurds

Hnbdethfn hnhthj`d pj`gjhrdlhbbusd vdrs `d lfs ld `jefgghssurd (gfhns lde`fhsfnndgdnt)

Jspdet dn afutfn ldgjnecdttd (ef``jr-auttfn)

Jaluethfn lds lfhits +++(! hnbdethfn lfrsj`d sjnsjaluethfn lds lfhits)


17/52

\rjhtdgdnt

Gdttrd ï p`jt `ds ldux

eftès ld `j efgghssurd+++

Ldux hnehshfns

Jttdnthfn jux pèlheu`ds(jrtãrd)


18/52


19/52

Hnbdethfns prfbfnlds=

`ds ijhnds lhihtj`ds dtlhihtf-ejrphdnnds


20/52

Jnjtfghd

@j ijhnd dst efnsthtuèd ld lduxefuecds ju sdhn ldsqud``dsehreu`dnt `ds tdnlfns

Gdgarjndusd= tuad synfvhj`e`fs ï sds ldux dxtrèghtès -ldux efuecds synfvhj`ds(vhseèrj`d dt pjrhètj`d)

Qètheu`jhrd= `ds pfu`hds

Lfy`d MQ. Jnjtfgy fb tcd fidxfr tdnlfn scdjtc jnl pu``dy systdg. M Cjnl Uuri :833;:5J=


21/52

Jnjtfghd

Lu ef` lds gètjejrphdns junhvdju ld `‘H_L sur hnldx,gjmdur, jnnu`jhrd

_jssd dn jvjnt ldsstrueturds fssdusds (_: dt_1), p`jquds pj`gjhrds (G_,H__, H_L) dt `hijgdntpj`gjhrd prfbfnl

Afrl prfxhgj` dt lhstj` ld `j ijhnd ju ef` ldsgètjejrphdns dt ï `‘H_L (!). BL_, (prfbfnl) BLU

(supdrehd`), __ (p`jqud pj`gjhrd)


22/52

Jnjtfghd lds ijhnds lhihtf-ejrphdnnds

Nfgardusds vjrhjthfns

_drsfnnd n‘dst l‘jeefrl


23/52


@j ijhnd rjlhj`defggunhqud\FTMFTQU jvde `jijhnd lu B_@


24/52


@j ijhnd lu R efggunhqud ljns3?% lds ejs jvde `j afursd u`njhrd

lu ejnj` ejrphdn quh efnthdnt `dsfièechssdurs

GJHU

@ds hnbdethfns ld `j ijhnd lu Rnd s‘ètdnldnt qud rjrdgdnt juejnj` ejrphdn


25/52


Efggunhejthfn ljns 3?% lds ejs(Ijrlndr), 4?% (_fhrhdr dtQdsnhek ), 9: % (Uecd`lrup)

5?% lds ejs pfur _ch``hps=

efnsèqudned, fn nd lrjhnd qu‘julfhit +++

_ch``hps EU dt j`. \cd fidxfr synfvhj` scdjtc jnjtfgy fb tcd `htt`d nidr= j gjerfsefphe stuly. M Cjnl Uuri :884;1?J=252-2


26/52

4?% lds ijhnds lu Rs‘jrrítdnt ju nhvdjulu `hijgdnt pj`gjhrdtrjnsvdrsd

5?% sd efnthnudntjvde `j afursd u`njhrd

1?% s‘jrrítdnt ï `jpfu`hd J:


27/52

Ijhnds lhihtf-ejrphdnnds= jutrds vjrhjthfns

Efggunhejthfn dntrd `j ijhndu`njhrd (529 ejs)

Hnldx 4,:%Gjmdur


28/52

Ju pfhindt ijhnd u`njhrd dt rjlhj`defggunhqudnt ljns 4?% ï 3?% lds ejs

JET\D EJQ_J@ \TNND@ UXNLQFGD UDEFNLJQX \F _XFIDNHE \DNFUXNFRH\HUI. NFTQHUUJ\, D. BFTQNHDQ, M. Q. YDQ\CDQ, E. LTGFN\HDQ jnl @. LFTQUFTNHJN.

Mfurnj` fb Cjnl Uuridry (Arhthsc jnl Durfpdjn Rf`ugd, 1??2) 5:A= 2= 239―233


29/52

HGJIDQHD l‘TN _C@DIGFN Ï AJUET@D


30/52


31/52


32/52

Dspjeds prfbfnls ld `jgjhn

\cdnjr (`d +brèqudggdnt jttdhnt)

Gèlhf-pj`gjhrd

Cypftcdnjr

@ds hnbdethfns bfnt suhtd ï lds p`jhds, pjrbfhs ï und lhbbushfn `fej`d,rjrdgdnt cègjtfiãnds


33/52

_rèsdntjthfn e`hnhqud

efggund

Fdlãgd lfrsj` +++ (pjs l‘dxpjnshfnpj`gjhrd pfssha`d) sjub dspjed cypftcdnjr

D\

Fdlãgd pj`gjhrd dt lfu`durspj`gjhrds


34/52


35/52

Hnldx scdjtc-pj`gjr bjsehj

Jlluetfr bjsehj

Ghlpj`gjrsdptug

Bjsehj/Jll Jpfndurfshs jt _:

_rfxhgj`= `d ejnj` ejrphdn

Lhstj`= bjsehj trjnsvdrsd prfbfnl(Ukffi)


36/52

Hnbdethfn ld `‘dspjed tcènjrhdn

@j p`us brèqudntd

_`jhd `fej`d fu dxpjnshfnl‘un pc`digfn lu pfued,

hnldx fu gjmdur

Ifnfidgdnt hgpfrtjnt dtlfu`furdux

_fued dn jaluethfn« hrrèluetha`d » +++

_jrbfhs hnldx dn fidxhfn


37/52

Hnbdethfn ld `‘dspjed

tcènjrhdn

Dvf`uthfn vdrs `j bjed lfrsj`d pjrldstruethfn lu bjsehj ld `‘jlluetdur dtpjssjid lu pus dntrd `ds ecdbs lu :dr HFL


38/52

Zud`qudsdxdgp`dsl‘jaeãs

tcènjrhdn


39/52

\rjhtdgdnt

_js l‘hnehshfn ljns `‘jxd

ld `j efgghssurd(rètrjethfn)

Ldux hnehshfns sfuvdnt

Ahdn dbbfnlrdr musqu‘ïgh-pjugd +++


40/52


41/52

@hghtds jnjtfghquds ld `‘dspjedgèlhf-pj`gjhrd

_rfxhgj`= `d ejnj`ejrphdn

Lhstj`= bjsehjtrjnsvdrsd prfbfnl

(Ukffi)


42/52

Lfrsj`= Bjsehj lds 1ãgd dt

5ãgd hntdrfssduxpj`gjhrds dt pèrhfstd lds5,< dt 4ãgd gètjejrphdns

_j`gjhrd= ijhnd lds

fièechssdurs 5,< 4 dt bjsehjpj`gjhrd

Qjlhj`= Udptug fa`hqud

T`njhrd= Udptug cypftcdnjrdntrd `d bjsehj pj`gjhrd dt`d 4ãgd gètj

B`ynn, :8


43/52


gèlhf-pj`gjhrd _`us rjrd= sfht p`jhd pènètrjntd

sfht èvf`uthfn l‘un pc`digfnlu HR/R

_jugd tdnlud, lfu`furdusd

_drtd ld `j efnejvhtè pj`gjhrd

_fshthfn dn fidxhfn lds HHH dt HR«

rèluetha`d

»

Fdlãgd lfrsj`


44/52

\rjhtdgdnt

Lrjhnjid echrurihej`(lhbeh`d ejr `ds thssusef``dnt dt `j rèihfn dst« rhecd »)

_`ushdurs hnehshfnspfssha`ds (ahdn vfhr)


45/52


cypftcdnjr \rãs rjrd, suhtd ld

p`jhds _js l‘dxpjnshfnpfssha`d

Lfu`dur dt ifnfidgdnt`fej`hsè (pjs lfrsj`)


46/52

Lhseusshfn= `d bjgdux sdptug gdlhf-pj`gjhrd dxhstd t‘h` 6

Nfn 6 ldux dspjeds hnbdethdux dn prjthqud gjhs pjs ld vrjhdsèpjrjthfn


47/52


48/52

Dspjed ld _jrfnj (Brjnedsef _jrfnj, :392)

Lhstj`= `d ejnj` ejrphdn

_rfxhgj`= `ds guse`dsfièechssdurs supdrehd`s

Lfrsj`= _rfnjtfrqujlrjtus dt gdgarjndhntdrfssdusd

_j`gjhrd= ̀ ds fièechssdurs

34% lds


49/52

34% ldspjthdnts=efggunhejthfn

dntrd `dsafursds rjlhj`ddt u`njhrd, dtjvde `‘dspjed

gèlhf- j`gjhrd


50/52


51/52

Hnbdethfn ld `‘dspjed ld _jrfnj

J pjrthr lu pfued = 9 ejs

J pjrthr ld `j ijhnd u`njhrd= : ejs

J pjrthr ld `‘dspjed gèlhf-pj`gjhrd= : ejs

1 hntdrvdnthfns dn gfydnnd (:-4)

Ucjrgj KU. Upjed fb _jrfnj hnbdethfns. M_QJU 1?:5;22=823-891

D è l


52/52

Dn pfstfpèrjtfhrd dt ljns

tfus `ds ejs _jnsdgdnts rèpètès

Gfah`hsjthfn prèefed (ljns und ajsshnd jvde ld`j aètjlhnd lh`uèd pjr dxdgp`d)

Hggfah`hsjthfn dt surèvj`ujthfn dntrd `ds

sèjnedsJnthahftcèrjphd jljptèd (prè`ãvdgdnts +++)

infections main poignet 2015 2016

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