{"id":95,"date":"2014-11-29T15:24:46","date_gmt":"2014-11-29T14:24:46","guid":{"rendered":"http:\/\/mboudry.wordpress.com\/?page_id=95"},"modified":"2019-08-18T19:10:13","modified_gmt":"2019-08-18T17:10:13","slug":"emploi-du-sn-13-pose","status":"publish","type":"page","link":"https:\/\/mboudry.fr\/thesewp2\/emploi-du-sn13\/emploi-du-sn-13-pose\/","title":{"rendered":"Emploi du SN 13 : Pose"},"content":{"rendered":"<p><strong>POSE DU SN 13<\/strong><\/p>\n<p>Nous ne reviendront pas sur les lignes d&rsquo;incision cutan\u00e9es, diff\u00e9rentes, suivant le type et le si\u00e8ge de la l\u00e9sion. L&rsquo;illustration correspond \u00e0 une section th\u00e9orique d&rsquo;un fl\u00e9chisseur superficiel en zone 5.<\/p>\n<p>Donc, apr\u00e8s exposition de la l\u00e9sion, identification des extr\u00e9mit\u00e9s tendineuses, successivement, il faudra :<\/p>\n<ul>\n<li>-*Introduire dans l&rsquo;extr\u00e9mit\u00e9 PROXIMALE du tendon, \u00e0 2 \u00e0 3 centim\u00e8tres au-dessus de la section, l&rsquo;aiguille DROITE (<span style=\"color: #000080;\">1<\/span>). Cette aiguille devra cath\u00e9t\u00e9riser suivant son axe l&rsquo;extr\u00e9mit\u00e9 tendineuse pour ressortie au centre de la tranche tendineuse (<span style=\"color: #000080;\">2<\/span>). Une traction sur le fil am\u00e8ne alors l&rsquo;ardillon au contact de la surface tendineuse. On v\u00e9rifie que l&rsquo;ardillon est bien \u00e0 plat sur la surface tendineuse (<span style=\"color: #000080;\">3<\/span>).<\/li>\n<li>-* Cath\u00e9t\u00e9riser, avec la m\u00eame aiguille droite l&rsquo;extr\u00e9mit\u00e9 distale du tendon. Celle-ci p\u00e9n\u00e9trant au centre de la tranche tendineuse (3), devra ressortir \u00e0 2 ou 3 centim\u00e8tres en aval, pour enfin traverser les t\u00e9guments de dedans en dehors, suivant l&rsquo;axe du tendon (<span style=\"color: #000080;\">4<\/span>)<br \/>\n-* Apr\u00e8s avoir v\u00e9rifi\u00e9 le positionnement de l&rsquo;ardillon, le fil pourra \u00eatre mis en tension, en cr\u00e9ant une l\u00e9g\u00e8re plicature du tendon. Le blocage sera r\u00e9alis\u00e9 par un plomb s\u00e9par\u00e9 des t\u00e9guments par une rondelle caoutchout\u00e9e, et \u00e9cras\u00e9 \u00e0 la pince forte sur le fil en tension (<span style=\"color: #000080;\">5<\/span>).<\/li>\n<li>-* Quelques points \u00e9pitendineux, au monofil nylon tr\u00e8s fin, compl\u00e8teront la suture tendineuse (FLEXOCRIN 5\/0 ou MERSILENE) (<span style=\"color: #000080;\">6<\/span>). Ils limitent la rotation des extr\u00e9mit\u00e9s tendineuses.<\/li>\n<li>-* Ext\u00e9riorise l&rsquo;extr\u00e9mit\u00e9 amont du SN13, gr\u00e2ce \u00e0 l&rsquo;aiguille courbe, suivant l&rsquo;axe du tendon. Bloquer sans tension excessive le fil par \u00e9crasement du plomb, isol\u00e9 des t\u00e9guments par son disque caoutchout\u00e9 (<span style=\"color: #000080;\">7<\/span>).<\/li>\n<li>-* On terminera en coupant \u00e0 1 centim\u00e8tre les extr\u00e9mit\u00e9s du fil d&rsquo;acier d\u00e9passant des plombs. Suture cutan\u00e9e \u00e0 l&rsquo;ordinaire au monofil nylon.<\/li>\n<li>-* L&rsquo;aspect final, SN13 en place est montr\u00e9 par la photo (<span style=\"color: #000080;\">8<\/span>).<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<table style=\"height: 140px; width: 210px;\" border=\"1\" cellspacing=\"1\" cellpadding=\"1\" align=\"left\">\n<caption><strong>Pose SN13<br \/>\nrenvoi texte &gt; num\u00e9ro photo<\/strong><\/caption>\n<tbody>\n<tr>\n<td style=\"text-align: center; vertical-align: middle; background-color: #cccccc; width: 105px; height: 70px;\"><span style=\"color: #000080;\"><span style=\"font-size: 24px;\"><strong>1<\/strong><\/span><\/span><\/td>\n<td style=\"text-align: center; vertical-align: middle; background-color: #cccccc; width: 105px; height: 70px;\"><span style=\"color: #000080;\"><span style=\"font-size: 24px;\"><strong>2<\/strong><\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td style=\"text-align: center; vertical-align: middle; background-color: #cccccc; width: 105px; height: 70px;\"><span style=\"color: #000080;\"><span style=\"font-size: 24px;\"><strong>3<\/strong><\/span><\/span><\/td>\n<td style=\"text-align: center; vertical-align: middle; background-color: #cccccc; width: 105px; height: 70px;\"><span style=\"color: #000080;\"><span style=\"font-size: 24px;\"><strong>4<\/strong><\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td style=\"text-align: center; vertical-align: middle; background-color: #cccccc; width: 105px; height: 70px;\"><span style=\"color: #000080;\"><span style=\"font-size: 24px;\"><strong>5<\/strong><\/span><\/span><\/td>\n<td style=\"text-align: center; vertical-align: middle; background-color: #cccccc; width: 105px; height: 70px;\"><span style=\"color: #000080;\"><span style=\"font-size: 24px;\"><strong>6<\/strong><\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td style=\"text-align: center; vertical-align: middle; background-color: #cccccc; width: 105px; height: 70px;\"><span style=\"color: #000080;\"><span style=\"font-size: 24px;\"><strong>7<\/strong><\/span><\/span><\/td>\n<td style=\"text-align: center; vertical-align: middle; background-color: #cccccc; width: 105px; height: 70px;\"><span style=\"color: #000080;\"><span style=\"font-size: 24px;\"><strong>8<\/strong><\/span><\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Pose <\/strong><\/p>\n<p><strong><a href=\"https:\/\/mboudry.fr\/thesewp2\/wp-content\/uploads\/2014\/11\/sn13-pose.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-133 size-full\" src=\"https:\/\/mboudry.fr\/thesewp2\/wp-content\/uploads\/2014\/11\/sn13-pose.png\" alt=\"SN13 pose\" width=\"1903\" height=\"2700\" srcset=\"https:\/\/mboudry.fr\/thesewp2\/wp-content\/uploads\/2014\/11\/sn13-pose.png 1903w, https:\/\/mboudry.fr\/thesewp2\/wp-content\/uploads\/2014\/11\/sn13-pose-211x300.png 211w, https:\/\/mboudry.fr\/thesewp2\/wp-content\/uploads\/2014\/11\/sn13-pose-768x1090.png 768w, https:\/\/mboudry.fr\/thesewp2\/wp-content\/uploads\/2014\/11\/sn13-pose-722x1024.png 722w\" sizes=\"auto, (max-width: 767px) 89vw, (max-width: 1000px) 54vw, (max-width: 1071px) 543px, 580px\" \/><\/a><\/strong><\/p>\n<hr \/>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><a title=\"Emploi du SN 13 : D\u00e9pose\" href=\"https:\/\/mboudry.fr\/thesewp2\/emploi-du-sn13\/emploi-du-sn-13-depose\/\">Page suivante<\/a><br \/>\n<a title=\"Emploi du SN 13 : G\u00e9n\u00e9ralit\u00e9s\" href=\"https:\/\/mboudry.fr\/thesewp2\/emploi-du-sn13\/emploi-du-sn-13-generalites\/\">Page pr\u00e9c\u00e9dente<\/a><br \/>\n<a title=\"Plan\" href=\"https:\/\/mboudry.fr\/thesewp2\/plan\/\">Plan du document<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>POSE DU SN 13 Nous ne reviendront pas sur les lignes d&rsquo;incision cutan\u00e9es, diff\u00e9rentes, suivant le type et le si\u00e8ge de la l\u00e9sion. L&rsquo;illustration correspond \u00e0 une section th\u00e9orique d&rsquo;un fl\u00e9chisseur superficiel en zone 5. Donc, apr\u00e8s exposition de la l\u00e9sion, identification des extr\u00e9mit\u00e9s tendineuses, successivement, il faudra : -*Introduire dans l&rsquo;extr\u00e9mit\u00e9 PROXIMALE du tendon, &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/mboudry.fr\/thesewp2\/emploi-du-sn13\/emploi-du-sn-13-pose\/\" class=\"more-link\">Continuer la lecture<span class=\"screen-reader-text\"> de &laquo;&nbsp;Emploi du SN 13 : Pose&nbsp;&raquo;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":11,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-95","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/mboudry.fr\/thesewp2\/wp-json\/wp\/v2\/pages\/95","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mboudry.fr\/thesewp2\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mboudry.fr\/thesewp2\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mboudry.fr\/thesewp2\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mboudry.fr\/thesewp2\/wp-json\/wp\/v2\/comments?post=95"}],"version-history":[{"count":3,"href":"https:\/\/mboudry.fr\/thesewp2\/wp-json\/wp\/v2\/pages\/95\/revisions"}],"predecessor-version":[{"id":550,"href":"https:\/\/mboudry.fr\/thesewp2\/wp-json\/wp\/v2\/pages\/95\/revisions\/550"}],"up":[{"embeddable":true,"href":"https:\/\/mboudry.fr\/thesewp2\/wp-json\/wp\/v2\/pages\/11"}],"wp:attachment":[{"href":"https:\/\/mboudry.fr\/thesewp2\/wp-json\/wp\/v2\/media?parent=95"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}