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<meta name="description" content="Le diagnostic de fracture doit être suspecté devant le contexte (chute sur la main ou le poignet, traumatisme direct). La douleur et/ou l&#039;impotence fonctionnelle sont souvent au premier plan. Une ouverture cutanée peut être associée. L&#039;examen clinique met en évidence le plus souvent une déformation qui peut être masquée par l&#039;œdème ou l&#039;hématome. Un trouble de rotation à l&#039;occlusion des doigts est évocateur d&#039;une fracture déplacée d&#039;un métacarpien ou d&#039;une phalange." />
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<title>La-Main.ch &#8211; Fracture du poignet: diagnostic et traitement </title>

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</header><div class="entry-content" itemprop="text"><h2 style="text-align: center;"><span style="color: #547ca4;">Quand suspecter une fracture?</span></h2>
<p>Le diagnostic de fracture doit être suspecté devant le <strong>contexte</strong> (<strong>chute</strong> sur la main ou le poignet, traumatisme direct). La douleur et/ou <strong>l&#8217;impotence fonctionnelle</strong> sont souvent au premier plan. Une ouverture cutanée peut être associée. L&#8217;examen clinique met en évidence le plus souvent une <strong>déformation</strong> du poignet, Il peut exister des trouvles nerveux (fourmis, deficit sensibilité).</p>
<hr />
<h2 style="text-align: center;"><span style="color: #547ca4;">Que faire en cas d&#8217;urgence?</span></h2>
<p>Une immobilisation de fortune permet le conditionnement pour le transport. La glace en application locale limite l&#8217;œdème et a un rôle antalgique, de même que la surélévation (écharpe). Les bagues doivent être ôtées avant que l&#8217;œdème ne s&#8217;installe. Il faut rester à jeun par principe (dans le cadre d&#8217;une prise en charge urgente) avant que le diagnostic ne soit confirmé</p>
<p><strong>Des circonstances particulières doivent inciter à une prise en charge rapide en urgences :</strong></p>
<ul>
<li>ouverture cutanée</li>
<li>déficit neurologique (perte de sensibilité, déficit moteur)</li>
<li>traumatisme à haute vélocité&#8230;.</li>
</ul>
<p>Dans le service des urgences ou au cabinet en urgences : la radio va confirmer la suspicion clinique. Parfois la découverte radiologique est fortuite car certaines fractures sont peu douloureuses comme les fractures non déplacées.</p>
<figure id="attachment_6587" aria-describedby="caption-attachment-6587" style="width: 243px" class="wp-caption alignnone"><a href="http://www.la-main.ch/wp-content/uploads/2020/12/2fracture-edr-2-e1497859434634-719x1024-1.jpg"><img class="wp-image-6587" src="http://www.la-main.ch/wp-content/uploads/2020/12/2fracture-edr-2-e1497859434634-719x1024-1-300x289.jpg" alt="radio montrant une fracture non deplacee du radius prise de face" width="243" height="234" srcset="http://www.la-main.ch/wp-content/uploads/2020/12/2fracture-edr-2-e1497859434634-719x1024-1-300x289.jpg 300w, http://www.la-main.ch/wp-content/uploads/2020/12/2fracture-edr-2-e1497859434634-719x1024-1.jpg 679w" sizes="(max-width: 243px) 100vw, 243px" /></a><figcaption id="caption-attachment-6587" class="wp-caption-text"><em>Radio : fracture non déplacée du radius : face</em></figcaption></figure>
<figure id="attachment_2106" aria-describedby="caption-attachment-2106" style="width: 133px" class="wp-caption alignleft"><a href="http://www.la-main.ch/wp-content/uploads/2017/06/fracture-edr-e1497859403939.jpg"><img class="wp-image-2106" src="http://www.la-main.ch/wp-content/uploads/2017/06/fracture-edr-e1497859403939-171x300.jpg" alt="radio montrant une fracture deplacee extra articulaire du radius prise de profil" width="133" height="233" srcset="http://www.la-main.ch/wp-content/uploads/2017/06/fracture-edr-e1497859403939-171x300.jpg 171w, http://www.la-main.ch/wp-content/uploads/2017/06/fracture-edr-e1497859403939-768x1346.jpg 768w, http://www.la-main.ch/wp-content/uploads/2017/06/fracture-edr-e1497859403939-584x1024.jpg 584w, http://www.la-main.ch/wp-content/uploads/2017/06/fracture-edr-e1497859403939.jpg 946w" sizes="(max-width: 133px) 100vw, 133px" /></a><figcaption id="caption-attachment-2106" class="wp-caption-text"><em>Radios : Fracture déplacée extra articulaire radius : profil</em></figcaption></figure>
<h2></h2>
<h2></h2>
<h2></h2>
<h2></h2>
<h2></h2>
<hr />
<h2 style="text-align: center;"><span style="color: #547ca4;">Traitement d&#8217;une fracture du poignet</span></h2>
<p>Si la fracture <strong>n’est pas déplacée</strong> un traitement conservateur sera préconisé le plus souvent (<strong>immobilisation</strong>). Des contrôles <a href="https://www.la-main.ch/2012/12/radiologie/">radiologiques</a> sont impératifs pour vérifier l&#8217;absence de déplacement secondaire.</p>
<p>Si la fracture est déplacée ou si elle atteint la surface d’une articulation le traitement est le plus souvent chirurgical et consiste à réaliser une <strong>réduction</strong> (repositionnement) de la fracture suivie souvent par une <strong>ostéosynthèse</strong> (fixation) à l’aide de matériel (<strong>plaque-vis</strong>, broches, fixateur externe). L&#8217;utilisation de <strong>plaques vérouillées</strong> de dernière génération permet une rééducation précoce. Si il n&#8217;y a pas de signes de compression nerveuse ou d&#8217;ouverture cutanée, l&#8217;opération peut être décalées de quelques jours sans préjudices pour le patient.</p>
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