cours dupuytrendiu 2014

8/9/2019 Cours DupuytrenDIU 2014

1/98

J`s trfetà`dts aiebfux i`

jf afjfie` i` Iupuytr`d `tjfpodvrotoae` jfemuejj`

Afre` Wfsbfj` Afd`tNJ J@SAPREFP[

-Pdet Skuaftojomequ` i`s Fhh`bteods i` jf AfedPSFAKpetfj Jfrecoeser`

-Kpetfj i` Jf Broex Rfedt REAOD, WFSER

Sà`rbeà`dts fu Ir N.W.Y`yssìou

Bours IEP iu 62/63/3769


2/98

Hfbt`urs i` resqu` r`boddus

! Mdtequ`> 07% i` bfs hfaejefux

! Iefct`> 37% i`s iefctequ`s

! Fjbooj

! Yfcfb

!

Aiebfa`dts> pkdocfrcetfj, fdte froaftfs`s! Fjmoiystropke`


3/98


4/98

WS@IERWOREYEOD M@D@YEVP@ (Md`s rmujftùrs

i`s a`tfjjoprotfs`s, YMH, FSD a`ssfm`rs..)

Esbkae` je` fu Iefct`,Yfcfb,

aebrotrfuaftesa`s,

Fjbooj Wkdocfrcetfj

FYW!Kypoxfdtked`

[I![O"YM

Atfcojesa`

iu bkoj`stroj

Wroiubteod i`

rfiebfux jecr`s

Wrojehrfteod

hecrocjfstequ` "JWFAebro-ruptur`s

iu hfsbef

EJ6 Fbtevfteod i`s

pjfqu`tt`s

Jefesod fux

rb`ptùrs i`s

ayohecrocjfst`s

YMH#, @MH(c),

WIMH, @MH

Rteaujfteod i`s

b`jjuj`s i`

Jfdm`rkfds

Iehhr`dtefteod i`s hecrocjfst`s

`d ayohecrocjfst`s

Bojjfmd` 2

Hecrod`bted`

YEAW

@pessfm`

(FSD) i` jf

hecrod`bted`

Fbtevfteod

i` jf

ayosed`

Fbtevfteod i` jf

ayosed` ledfs`

Ieaeduteod i` jFAW edtrf b`j !Bf++

Bodtrfbteod

fbted` ayosed`

YMH1 Yrfdshoraedm mrowtk hfbtor @MH1 hfbtùr i` broessfdb`

pei`raequ` WIMH1 Wjft`jì i`revì mrowtk hfbtor JWF1

jepei`s i` mroup` F (`diotoxed` t steaujfdt tessujfer`)

A`tfjjoprotedfs`s 1 mjftedfs`s, bojjfmdfs`s AAW

(a`tfjjoprotfs`s aftrebe`jj`s AAWseapjequ`s ifds j`

ràoi`jfm` i` jf aftreb` `xtrfb`jjujfer`) Isedtmred` `t

bystoproted` (`dbor` fpp`j`s FIFAs fyfdt ud rj` ifds jf

aemrfteod t jfikseod b`jjujfer`) WORYDp`reosted ostòcjfst`

sp`beheb hfbtor, md` jobfjes` sur j` bkroaosoa` 62 ("surve` b`jj.)Hemur` 6 Wkyseopftkojome` i`

jf ieftks` i` Iupuytr`d

(ifprs Fj-Vfttfd (60)

Sfpp`j pkyseopftkojomequ`


5/98

J`s trfet`a`dts aiebfux! Is jfppfreteod iud hj`xua iu

ioemt fubud trfet`a`dt aiebfjd`st fbteh sfds s`bteod abfdequ`

ou `dzyaftequ` i`s bori`s! Jf bojjfmdfs``st `d

`xprea`dtfteod i`pues 67 fds `t`st boaa`rbefjes` i`pues 3767

! Jfpodvrotoae` jfemuejj``stutejes` i`pues pjus i` 97 fds


6/98

J`s trfet`a`dts aiebfux fcfdiodds

bfr ed`hhebfb`s ou ifdm`r`ux

! J`s bytojytequ`s! Jf rfieotkrfpe`! Jfjjopuredoj!

J`s edn`bteods jobfj`siedt`rhrods! J` Wotcf*


7/98

J`s trfet`a`dts aiebfux

utejes`s sfds pr`uv`s! Jfbupudbtur`!

Jf asotkrfpe`! Jkoaopftke`! Jf vetfaed` @! Jf

pkytotkrfpe`


8/98

@d jfcs`db` i` trfetà`dt i`sbfus`s, iùx trfetà`dts fdte-hecrosfdts sodt bfdieifts jf

prv`dteod i`s r`bkut`s

!

Jf Bojbkebed` !

J` Xrfpfaej(Esopted`*)


9/98

Jf bojbkebed`! Fbteod fdte-edhjfaaftoer` `t fdte-

hecrosfdt`! F t utejes` ifds jf sbjroi`rae`! Wjus fbtev` qu` jf bortebotkrfpe`

ifds jf hecros` pujaodfer`eieopftkequ`

! Ssujtfts proa`tt`urs afesedbodstfdts ifds j` Iupuytr`d `t j`jf W`yrode`


10/98

J` vrfpfaej(Esopted`*)

! Edkecetùr bfjbequ` bfrieo-sj`bteh

! edkec` ed vetro `t ed vevo jf sydtks` iubojjfmd` )

! poaafi` fu vrfpfaej> `dverod 977P.R. iojjfrs j`s 677 mrfaa`s

!

ioet tr` fppjequ` troes hoes pfr nourp`difdt pjuseùrs aoes.

! fubud` tui` sreùs`


11/98

Jf bojjfmdfs` (6)! @dzya` dftur`j bjostreieua

kestojytebua! Edn`bteods ifds j`s bori`s

fpodvrotequ`s sueve`s i` trfbteodafdu`jj`

! Ssujtfts prjeaedfer`s edtr`ssfdts(Cfifjfa`dt` `t bojj. 3777 `t 3773)

! Afes utejesfteod edt`riet` (cr`v`t`)`t rbeiev`s prbob`s

! Sesqu` pot`dte`j pour j`s t`diods


12/98

Jf bojjfmdfs` (3)tui` i` Kurst fdi boj. `d 3775(D`w @dmj N A`i 3775R`p 2 58;-=5

! tui` aujteb`dtrequ` rfdioaes` `dioucj` fv`umj` bodtr` pjfb`co 27;

pfte`dts< hj`xeod sup 37! 6 2 edn`bteods i` 7,0; am (tous j`s 27nours) `t trfbteod hort` 6 nour fprs

!

@hhebfbet sur jf aocejet frtebujfer`> 92,5 ;7,=vs pjfb`co 90,2 95,0 p!7.776


13/98

W`rb`dt

7

67

37

27

97

07

87

=7;7

57

677

FF9077 (d 1 372) Wjfb`co (d 1 672)

7-067-6037-3027-2097-9007+

Bodtrfbtur` Bft`mory Fht`r Jfst Edn`bteod

!"#"$

&'('

)"*!

+,#-$

&'('

).*!

/763 2

"## %&'()&* +,'-./AEYY Wopujfteod (d 1 278)

!9+$ "-9-$


14/98

Jf bojjfmdfs` (2)tui` i` Kurst fdi boj. `d 3775(D`w @dmj N Aì 3775 R`p 2 58;-=5! @hh`ts s`bodifer`s cdeds `t trfdsetoer`s (60

nours)> 59%!

Modhjà`dt jobfj, ioujùr, bodtuseod, pruret,fidopftke`s rmeodfj`s trfdsetoer`s! Suptur`s t`diedùs`s 6%! Fjmoiystropke` 6/277! Bot 077$ jf ios` fux PRF (boaa`rbefjes `d 3767)

FAA ùrop`dd` d 3767

! edtrt mros doiuj`s `t Jìi`rkos` ?!

Pd` sùj` edn`bteod pfr aoes ?


15/98

3 bfs`s oh Boji Edtoj`rfdb` hojjowedm BBK. Ledm E.B.B. `t fj. N Kfdi Rurm Fa. Xoj.25,3769.79, ;7;-5


16/98

"76 )-.' 7,##)32-)/9 0 8=; 5)>&&


17/98

Yrfet`a`dt pfr jf bojjfmdfs`

Afjfie` i` Iupuytr`d

%9'(9& C"6 I @)-H MK&3 "(6B =N:LJL8"A:=D==

Fdteborps fdte-bojjfmdfs`

fprs6 edn`bteod

;3%

fprs

3 edn`bteods

58%

Sesqu`s pot`dte`jsdod iaodtrs / pfs `xbjus

!futo-eaaudet iurfcj` `d pfrte`edkecetreb`>!fuma`dt`r jf ios`?,!afjfie`s srequ`s au`tt`s, rv`rsecj`s!couhh`s i` afjfie`s eaaudojomequ`s ?!

afjfie` BEB ?!bkob fdfpkyjfbtequ` ?

Wredbep` i` prbfuteod ?Fubud` afjfie` edhjfaaftoer`fprs ; edn`bteods / r`buj 67 fds

Edt`rprtfteod trop iomaftequ` ?


18/98

Bojjfm`dfs` (9)

! @tui` bout/`hhebfbet(N Kfdi Rurm Fa, dov3766) > Hfsbe`btoae` dod r`dtfcj`,

fpod`vrotoae` 4 bojjfmdfs`! @HH@YR R@BODIFES@R/

Iejfbrfteod butfd` svr` (Wjfst S`bodstr

Rurm, nfdv 3763) Suptur` t`died`us` (N Kfdi Rurm Fa, fum

3766)


19/98


O')>9W VK&,>9)- S9R/'.96 Y..>A44W')>9W69K

bodtrfbtur` Sesqu`

: 97 07 %

4 97 =6 %

Sesqu`s i` rbeiev`


20/98

I`rder` tui` FP[-BB-;09 dod pucje`

;37 edn`bteods ifds 0;5 bori`s! 5;.3% i`hh`ts ediserfcj`s cdeds V.R.! Hrqu`db` dod fuma`dt` se rpteteod i`s edn`bteods (;

edn.)! 25 `hh`ts ediserfcj`s svr`s

Iodt ud` tkroacos` vèdùs` prohodi`@t ud` t`diedet` s`bodifer`Suptur` ?

! Fprs jf 9aèdn`bteod, j`dsàcj` i`s pfte`dts odt iv`jopp i`sfdteborps fdte bojjfmdfs`s FP[-E `t/ou FP[-EE sfds r`t`dtessà`dtbjedequ` de rfbteod fdfpkyjfbtequ` ocs`rv`.

Sesqu` jodm t`ra` ? afjfie` futo-eaaud` ?


21/98

Boapt` t`du i` >- jfcs`db` i` boapfrfesod iu [EFW@[ ud` t`bkdequ` p`rted`dt` (FWF, bkerurme`) hora`s svr`s `t

boapj`x`s (00 afeds, 60= rfyods)! ;+/-2 fpodvrotoae`s `d 6 sfdb`!

Ssujtfts boapfrfcj`s jfpodvrotoae` seapj`! edbei`dts rsojutehs (3%)! A`sur` i`s fdmj`s, edbfpfbet (sbor`

@XF) `t sfteshfbteod iu pfte`dt! D`tt` fajeorfteod p`rsestfdt` 6;

aoes (52% i` sfteshfbteod)


65/98

! J` bot bodoaequ` `t sobefj r`st`hfecj` (i` jorir` i` 877 !)

! Wfs i` sfjj` ioprfteod

! Wfs ifrrt i` trfvfej (sfuh trfvfuxsfjessfdts)

! Wfs i` soeds post oprftoer`s

!

Wfs i` riubfteod

J jte t e


66/98

Jf aujte fpodvrotoae` jfemuejj`


67/98

F t e


68/98

Fpodvrotoae` v`rsusfpodvr`btoae`! Xfd Senss`d (3778 @Y 3763)>tui`

prosp`btev`, bodtrj` rfdioaes`

! @hh`bteh 662< r`buj 0 8 s`afed`s

!

Bretr`s> ihebet i`xt`dseod, stfi`s i`Yucefdf, sbor` iedbfpfbet IFRK(7-677), sfteshfbteod iu pfte`dt(7-67)


69/98

Ssujtfts>

! Siubteod iu hj`xua> fpodvrotoae`edh fpodvr`btoae` 82% vs =5%p17,76

! Siubteod sbor` iedbfpfbet IFRK>fpodvrotoae` sup> 5 vs 68, p1 7,76=

! Rfteshfbteod( 7-67) fpodvrotoae` supp1 7,772

B je te t e 07% i


70/98

! Boapjebfteods fpodvrotoae`> 07% i`hessur`s butfd`s!!!! 2% i`

pfr`stkse`s! Boapjebfteods i` jfpodvr`btoae`>

sur 0= bfs> 6 edh`bteod, 6 kaftoa`,62 pfr`stkse`s (p>7,70), 6kypo`stkse`, 6 s`bteod bojjftrfjr`pres`

! Roet 02%!! pour jfemuejj`

!

27% pour j` cestoure


71/98


Xfd Senss`d. 0-y`fr r`sujts oh SBY od ttt ed II > WDH vs JH. Wjfst S`bod Kfdi Rurm =N:= P9RJ:=G5=1AXFGD]]6

S`brutà`dt>35 aoes/5 bker/ttt pfr 3 bkerurme`ds/666 pft/660 afeds/688 rfyods

FWF8 sàfed`sSfys Y@WI

HJ8 sàfed`sSfys Y@WI

Sbeiev`s *0 fds

WDH JH

YW@Ieaprovà`dt ;; 82% =; =5%

;9,5%

37,5%

* S`beiev`s> 427

Fpodvrotoae` jfemuejj` v`rsus Hfsbe`btoae` jeaet`

Y@WI> Yotfj @xt`dseod Wfssev` I`hebet

Sbeiev`s0 fds

Cfioes6552

632 afeds06,8%

Sbeiev`s05 aoes

Soqu`t3763

377 afeds2=,7%

J ei t i


72/98

J`s fbbei`dts i`jfpodvrotoae` jfemuejj`

! Rodt rfr`s (aoeds i` 6 p 6777)

!

ruptur` iu t`diod hjbkess`ur! s`bteod iu d`rh bojjftrfj

! Wkj`maod i`s mfed`s >`xb`pteodd`j


73/98

J@R SPWYPS@R Y@DIED@PR@R

!

Rodt `xb`pteodd`jjà`dt eaaieft`s

! @d mdrfj sàe-tfriev`s ou tfriev`s

(ud` troes sàfed`s)

! Wrv`dteod pfr ud` codd` t`bkdequ` `tpfrtebujer` ftt`dteod bk`z jf hàa`,fu poub` `t ifds j`s rbeiev`s postbkerurmebfj`s


74/98

J`s edbei`dts


75/98

J`s edbei`dts! hessur`s butfd`s

qu`jqu`s pourb`dts

! iys`stkse`strfdsetoer`s,s`pses,kaftoa`s,ioujùrs post-

fpodvrotoaeèdhreùrs 6 %

! Fjmoiystropke``xb`pteodd`jj`

BOAWJEBFYEODR


76/98

BOAWJEBFYEODRBKESPSMEBFJ@R

! R`bteod d`rv`us` > 0,3%! Dbros` prohodi` > 3,6%! R`bteod frtre`jj` > 6,;%!Fjmoiystropke` > 6,;%!

Edh`bteod >6%! .Bebftreb` >677%


77/98

DOYEODR EAWOSYFDY@R


78/98

DOYEODR EAWOSYFDY@R

! J` trfetà`dt i` jf hj`xeodatfbfrpo-pkfjfdme`dd` `str`jftevà`dt hfbej` afes

j oprftùr d `st j fes` qu fprsud` b`dtfed` i fpodvrotoae`s

! J` trfetà`dt i` jf hj`xeodedt`rpkfjfdme`dd` `st iehhebej` `tdb`sset` ud` eaportfdt` prftequ`

! Jfpodvrotoae` jfemuejj` `st ud` t`bkdequ`


79/98

j femuejj` `st ud` t`bkdequ`iehhebej` surtout ifds j`shora`s iemetfj`s

! @jj` ioet tr` rs`rv` fuxprftebe`ds `xprea`dts

! Ifds b` bfs j`s

boapjebfteods sodt i` pjus`d pjus rfr`s `t j`srsujtfts i` pjus `d pjussfteshfesfdts

!

@d bfs i` r`bkut`,jfpodvrotoae` jfemuejj``st tounours possecj`

J` t`st i` jf tfcj`


80/98

J` t`st i` jf tfcj`


81/98

J` procja` i`s


82/98

J` procja` i`srbeiev`s

! Hrqu`dt`s> pjus i`07% 0 fds

!

Hfbtùrs hfvoresfdts>Fm`, kriet, iefct`fjboojesa`

! Hrqu`db` ei`dtequàiebo -bkerurmebfj`sfuh fv`b j`s mr`hh`s i`p`fu

Hfbtùrs i` rbeiev`s


83/98

Hfbtùrs i` rbeiev`s! Fm` > fvfdt 97 fds!

Kriet > mrfvet se fttèdt` i`s 3pfr`dts! Iefct` ( surtout edsujedo ip`difdt) >

possecejet i` hora`s i` jfioj`sb`db`)! Fjboojesa` (souv`dt fssobe fu

tfcfmesa` `t fux trfvfux i` horb`)!

J` mfridfj! @t surtout jfssobefteod i` pjuseùrs

hfbtùrs

Vu`jj`s hora`s post bkerurmebfj`s


84/98

Vu`jj`s hora`s post- bkerurmebfj`s p`ut-od trfet`r? (6)

! 3 hora`s post-bkerurmebfj`s> j`s rbeiev`spur`s pfrf-bebftrebe`jj`s `t j`s futr`s

jobfjesfteods.! bebftreb` rtrfbtej`> mr`hh` i` p`fu! bebftreb` soupj` > fpodvrotoae` jfemuejj`

afes possecejet i` aoiehebfteod i`s rfpportsfdftoaequ`s `t resqu` i` cj`ssur` d`rv`us`

Vu`jj`s hora`s post-


85/98

Vu`jj`s hora`s postbkerurmebfj`s

pùt-od trfet`r? (3)! 6558 -86 ioemts trfets-rsujtfts

eaaiefts boapfrfcj`s bùxoct`dus bk`z i`s pfte`dts dodoprs. F iùx fds, j`s rsujtftsr`st`dt cods ifds j`s stfi`s E, EE `tEEE, tfux i` rbeiev` i` 6;%< j`sstfi`s EX rbeiev`dt ifvfdtfm`

Vu`jj`s hora`s post-bkerurmebfj`s pùt-od


86/98

Vu`jj`s hora`s post bkerurmebfj`s p`ut odtrfet`r ? (2)

! Bebftreb` rtrfbtej`.

!

J` trfet`a`dt jfemuejj` `st ebeeapossecj`


87/98

Vu`jj`s hora`s post-bkerurmebfj`s p`ut-od


88/98

V p m ptrfet`r ?(0)

! Sbeiev` post-bkerurmebfj` fu EEEioemt fv`b hj`ssua i`

jEWW i` 20 `t fupoub`.

! Jfddujfer` d` pùtpfs tr` trfetaiebfjà`dt.

Vu`jj`s hora`s post-bkerurmebfj`s pùt-


89/98

V p m pod trfet`r ? (8)

! J` afn`ur `t j`

poub` sodt

r`ir`sss `d ud`sfdb`

ifpodvrotoae`

jfemuejj`.

S`st` tej ud` pjfb` pour jf bkerurme`?


90/98

OPE !! Ssujtfts edsuhhesfdtsi`

jfpodvrotoae` jfemuejj`! J`s hora`s aujte rbeievfdt`s(mr`hh`s i`

p`fu)!

J`s rfeiùrs i` jEWW(surtout j` 0a`rfyod) > frtkrojys`, frtkrois`.! J`s coutodder`s(surtout jEWW iu 0)!

J`s (trs rfr`s) ruptur`s t`diedùs`s `td`rvùs`s eftromd`s post FF! Edtrt +++ i`s stfhhs aiebfux

bkerurmebfux

J`s boussed`ts iorsfux i`s


91/98

J`s boussed`ts iorsfux i`spkfjfdm`s! Wkoto i'ud boussed`t

iorsfj i` pkfjfdm` `tsbkaf `d boup` i` jfjseod>

!

`d v`rt j` hfsbef iemetfjiorsfj iu ioemt `t jfafss` hecrùs`bodstetufdt j` boussed`tque fikr` jf p`fu,

! `d cjù j'fppfrèjt`diedùx `xt`dsùr iuioemt fuqu`j j` boussed`td'fikr` pfs.


92/98

Yrfet`a`dt>! Jedn`bteod sous


93/98

Yrfetà`dt>J edn`bteod souspr`sseod i` 7,30 ajiKyirobortfdbyj* (6 3 edn`bteods 60nours) `st j`trfetà`dt i` bkoex

J` rsujtft `st oct`du`d qu`jqu`s sàfed`s(fprs ud` pkfsìysbkroae` i` jfp`fu)

.J`xrs` bkerurmebfj``xpos` fu resqu` i`rbeiev` `t i`bkjoi`s


94/98

Afjfie` i` JFW@USODE@


95/98

BODBJPREODR (6)


96/98

BODBJPREODR (3)

( )


97/98

BODBJPREODR (2)

BO B R O R ( )


98/98

BODBJPREODR (9)

cours dupuytrendiu 2014

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