IAOM-US : Diagnostic et Thérapie Manuelle Orthopédique du Poignet et du Pouce

L’objectif de la formation est d’acquérir les dernières connaissances scientifiques dans l’évaluation et le traitement de la région de poignet et du pouce.

A la fin de la formation les participants devraient être capables :

• d’avoir une connaissance exacte de la patho-anatomie, de la physiologie et la biomécanique de la région du poignet et du pouce.
• d’être en mesure d’effectuer une évaluation clinique précise
• d’acquérir une méthodologie pour interpréter les examens cliniques afin d’offrir des diagnostics précis à vos patients.
• de mettre en place un cadre cohérent qui permet la prescription d’exercices spécifiques en fonction des problèmes rencontrés.
• d’obtenir les compétences permettant de combiner des techniques de mobilisations et manipulations articulaires avec celles orientées vers les tissus mous afin d’obtenir un traitement total de la région du poignet et pouce.
• d’acquérir la maitrise des meilleures techniques pour traiter les tendons, articulations, ligaments ainsi que les nerfs périphériques.
• de mieux comprendre la cinématique du coude et sa relation avec l’ensemble du membre supérieur sur un plan fonctionnel et pathologique.
• d’inclure l’aspect bio-psychosocial et les préférences des patients dans l’évaluation et le traitement de la région du poignet et pouce.
• d’acquérir un raisonnement clinique cohérent afin de mieux traiter la région du poignet et pouce.

Cet emploi du temps est donné à titre indicatif et peut être adapté en fonction des questions posées et du groupe. Les horaires pouvant varier de 15 à 30 minutes.

Jour 1

8h30 : Accueil

09h00 : Introduction

09h15 : Anatomie et physiopathologie du Poignet (articulations distales radio-ulnaire, radiocarpale et médiocarpienne)

10h30 : Pause

10h45 : Anatomie de surface et palpation de la région du poignet

12h00 : Examen Clinique de la région du poignet/pouce: Anamnèse

12h30 : Déjeuner

13h30 : Examen Clinique du poignet/pouce

14h30 : Interprétation de l’examen clinique du poignet/pouce

15h30 : Pause

15h45 : Tests et mobilisations spécifiques de l'articulation radio-carpienne et médio-carpienne: restauration de la flexion et de l'extension, déviations radiales et ulnaires: techniques de rangées et de colonnes – Mobilisations et manipulations

17h30 – 18h15: Instabilité du poignet : pathoanatomie et testing

Jour 2

8h30 : Revue du premier jour

08h45 : Instabilité du poignet : pathoanatomie, testing et traitement

09h45 : Articulation trapéziométacarpienne : anatomie, cinématique, testing et mobilisations / manipulations articulaires des doigts

11h15 : Pause

11h30 : Douleurs ulnaires du poignet : Diagnostic différentiel et traitement.

12h30 : Déjeuner

13h30 : Douleurs radiales, antérieures et postérieures du poignet : Diagnostic différentiel et traitement.

15h00 : Pause

15h15 : Syndrome du canal carpien

16h00 : Cas cliniques

17h00 - 17 :15 : Questions et remarques de clôtures

• Enseignement par diaporamas
• Démonstrations pratiques
• Cas cliniques

Entre binômes de participants et sous contrôle de l'intervenant pour les sessions pratiques.

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• Adeodato SC, de Oliveira NS, de Campos Pessoa AL, de Sant’Anna MM, Neto BC, de Oliveira LP. The Dorsal Scapholunate Ligament Complex: Anatomical Description and Correlation with Lunate Morphology. Journal of Hand Surgery Global Online. 2026 Mar 1;8(2):100921.
• Anekstein Y, et al. What is the best way to apply the Spurling test for cervical radiculopathy? Clin Orthop Relat Res. 2012. 470:2566-2572.
• Beeres FJP et al. Diagnostic strategy for suspected scaphoid fractures in the presence of other fractures in the carpal region. J Hand Surg 2006;31B:416-18.
• Berger RA. The anatomy of the ligaments of the wrist and distal radioulnar joints. Clin Orth Rel Res 2001; 383:32-40. 
• Bordalo-Rodrigues M, Schweitzer M, Bergin D, Culp R, Barakat MS.Lunate chondromalacia: evaluation of routine MRI sequences. Am J Roentgenol. 2005;184(5):1464-9.
• Boudier-Revéret M, Gilbert KK, Allégue DR, Moussadyk M, Brismée JM, Sizer Jr PS, Feipel V, Dugailly PM, Sobczak S. Effect of neurodynamic mobilization on fluid dispersion in median nerve at the level of the carpal tunnel: A cadaveric study. Musculoskeletal Science and Practice. 2017 Oct 1;31:45-51.
• Brown RK, CA Peimer. Changes in digital flexor tendon mechanics after endoscopic and open carpal tunnel releases in cadaver wrists. Journal of Hand Surgery - American Volume, 2000; 25A:112-119.
• Chan JC, Tiong WH, Hennessy MJ, Kelly JL. A Guyon's canal ganglion presenting as occupational overuse syndrome: A case report. J Brachial Plex Peripher Nerve Inj. 2008 12;3:4. 
• Chen HS, Chen MY, Lee CY, Kao MJ, Wang TG. Ultrasonographic examination on patients with chronic wrist pain: a retrospective study. Am J Phys Med Rehabil. 2007;86(11):907-11. 
• Chang MH, LH Liu, YC Lee, SJ Wei, HL Chiang, PF Hsieh. Comparison of sensitivity of transcarpal median motor conduction velocity and conventional conduction techniques in electro-diagnosis of carpal tunnel syndrome. Clin Neurophysiol 2006;117:984-991.
• Concannon MJ, ML Brownfield, CL Puckett. The incidence of recurrence after endoscopic carpal tunnel release.  Plastic and Reconstructive Surgery, 2000; 105:1662-1665.
• Davis A, Wilhelm MP, Pendergrass TJ, Sechrist DM, Brismée JM, Sizer Jr PS, Gilbert KK. Anatomical relationship of palmar carpal bone landmarks used in locating the lunate and capitate during palpation: A cadaveric investigation. Journal of Hand Therapy. 2019 Oct 1;32(4):463-9.
• Dawson JS, Martel AL, Davis TRC. Scaphoid blood flow and acute fracture healing. J Bone Joint Surg 2001; 83-B: 809-814. 
• Đilvesi Đ, Jelača B, Knežević A, Živanović Ž, Pantelić V, Golubović J. Evolution of Carpal Tunnel Syndrome Treatment: A Narrative Review. NeuroSci. 2026 Jan 12;7(1):10.
• Dodds SD, Panjabi MM, Slade JF 3rd Screw fixation of scaphoid fractures: a biomechanical assessment of screw length and screw augmentation. J Hand Surg [Am]. 2006 Mar;31(3):405-13. 
• Finsen V, Zeitlmann H. Carpal tunnel syndrome during pregnancy. Scand J Plast Reconstr Surg Hand Surg. 2006;40(1):41-5.
• Ghali M, Ehlen QT, Kholodovsky E, Cacciatore J, Parrish J, Jenkins N, Dodds SD. Double Crush Syndrome: A Review of the Literature. HAND. 2025 Jul 20:15589447251352122.
• Ginanneschi F, Milani P, Mondelli M, Dominici F, Biasella A, Rossi A. Ulnar sensory nerve impairment at the wrist in carpal tunnel syndrome. Muscle Nerve. 2008;37(2):183-9.
• Givissis P, A Christodoulou, B Chalidis, J Pournaras. Neglected trans-scaphoid trans-styloid volar dislocation of the lunate. J bone joint Surg Br, 2006; 88:676-680.
• Gong HS, MS Chung, YH Lee, S Lee, JO Lee, GH Baek. Arthroplasty for advanced Kienbock's disease using a radial bone flap with a vascularised wrapping of pronator quadratus. J Bone Joint Surg 2006;88B:623-628.
• Hagert E. Proprioception of the wrist  joint: A review of current concepts and possible implications on the rehab ilitationof the wrist . J Hand Ther 2010;23:2-17.
• Hansen LM, Jiang EX, Hodson NM, Livingston N, Kazanjian A, Wu M, Day CS. Patients With and Without Double Crush Syndrome Achieve Similar Rates of Clinical Improvement Following Carpal Tunnel Release. Hand. 2025 Jun;20(4):549-54.
• Haugstvedt JR, Berger RA, Nakamura T, Neale P, Berglund L, An KN. Relative contributions of the ulnar attachments of the triangular fibrocartilage complex to the dynamic stability of the distal radioulnar joint. J Hand Surg [Am]. 2006;31(3):445-51.
• Harbrecht A, Unglaub F, Langer MF, Müller LP, Hug U, Spies CK. Instability of the Distal Radioulnar Joint. Deutsches Ärzteblatt International. 2025 Jun 13;122(12):321.
• Holloway M, Cady-McCrea C, Carroll T, Wilbur D, Molinari R. Order of surgical intervention in double-crush syndrome. European Spine Journal. 2025 Aug 29:1-7.
• Hooper TL, Denton J, McGalliard MK, Brismée JM, Sizer PS. Thoracic outlet syndrome: a controversial clinical condition. Part 1: anatomy, and clinical examination/diagnosis. Journal of Manual & Manipulative Therapy. 2010 Jun 1;18(2):74-83.
• Hooper TL, Denton J, McGalliard MK, Brismée JM, Sizer Jr PS. Thoracic outlet syndrome: a controversial clinical condition. Part 2: non-surgical and surgical management. Journal of Manual & Manipulative Therapy. 2010 Sep 1;18(3):132-8.
• Iwasaki N, A Minami, J Ishikawa, H Kato, M Minami. Radial osteotomies for teenage patients with Kienbock disease. Clin Orthop  Rel Res, 2005; 439:116-122.
• Johnson NA, Reay E, Jansen V, Rangan A. What is the most effective treatment for basal osteoarthritis of the thumb?. The Bone & Joint Journal. 2026 Jan 1;108(1):4-8.
• Jung JM et al. Changes in ulnar variance in relation to forearm rotation and grip. J Bone Joint Surg. 2001;83-B:1029-33.
• Kim JP, Park MJ.  Assessment of distal radioulnar joint instability after distal radius fracture: comparison of computed tomography and clinical examination results. J Hand Surg. 2008; 33A: 1486-1492.
• Koca N, Nazlıgül NK. Evaluation of wrist radiographic indices in people with idiopathic carpal tunnel syndrome: a prospective cross-sectional study. Annals of Physical and Rehabilitation Medicine. 2026 Mar 1;69(2):102068.
• Lane R, Tafti D, Varacallo MA. Scapholunate Advanced Collapse. 2024 Jan 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–.
• Leis AA, Wells KJ. Radial nerve cutaneous innervation to the ulnar dorsum of the hand. Clin Neurophysiol. 2008;119(3):662-6.
• Lindau T, Aldercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioular joint instability after distal radial fractures. J Hand Surg 2000; 25-A:464-8.
• Lohman C, Gilbert KK, Sobczak S, Brismée JM, James CR, Day M, Smith MP, Taylor L, Dugailly PM, Pendergrass TP, Sizer PS. Cervical Nerve Root Displacement and Strain During Upper Limb Neural Tension Testing: Part 2. Role of Foraminal Ligaments in the Cervical Spine. Spine. In Press; 2015.
• Lozano Calderón SA, Paiva A, Ring D. Patient satisfaction after open carpal tunnel release correlates with depression. J Hand Surg [Am]. 2008 Mar;33(3):303-7.
• Majima M, Horii E, Matsuki H, Hirata H, Genda E. Load transmission through the wrist in the extended position. J Hand Surg [Am]. 2008;33(2):182-8.
• Martins RS, Siqueira MG, Simplício H, Agapito D, Medeiros M. Magnetic resonance imaging of idiopathic carpal tunnel syndrome: correlation with clinical findings and electrophysiological investigation. Clin Neurol Neurosurg. 2008;110(1):38-45.
• Mashoof AA, Levy HJ, Soifer TB, Miller-Soifer F, Bryk E, Vigorita V. Neural anatomy of the transverse carpal ligaments. Clin orthop rel res. 2001; 386:218-221.
• McKenna ES, Co N, Brancaccio H, Soper B, Borole A, Han Y, Kirschenbaum D, Katt BM. Efficacy of Splinting in Managing Adult Trigger Finger: A Systematic Review of Short-Term Outcomes. Journal of Hand Surgery Global Online. 2026 Jan 1;8(1):100881.
• McLean KM, Sacks JM, Kuo YR, Wollstein R, Rubin JP, Lee WP. Anatomical landmarks to the superficial and deep palmar arches. Plast Reconstr Surg. 2008;121(1):181-5.
• Mee S. Wrist Instabilities. Cooper's Fundamentals of Hand Therapy-E-Book: Cooper's Fundamentals of Hand Therapy-E-Book. 2025 Sep 28:205.Moghtaderi A, Izadi S. Double crush syndrome: an analysis of age, gender and body mass index. Clin Neurol Neurosurg. 2008;110(1):25-9.
• Minkhorst K, Munn A, MacDermid J, Grewal R. Does orthosis improve outcomes of conservative treatment in trigger fingers? A 3-arm prospective randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2025 Dec 1;106(12):1798-806.
• Morimoto H, Viegas S, ElderKW, Nakamura K, DaSilva MF, Boyd NL, Patterson R. Scaphoid nonunions: A 3-dimensional analysis of patterns of deformity. J Hand Surg 2000; 25A: 520-528.
• Moritomo H, Viegas SF, Elder K, Nakamura K, DaSilva MF, Patterson RM. The Scaphotrapezio-trapezoidal joint. Part 2: A kinematic study. J Hand Surg 2000; 25A: 911-920.
• Moritomo H, Viegas SF, Nakamura K, DaSilva MF, Patterson RM. The Scaphotrapezio-trapezoidal joint. Part 1: An anatomic and radiographic study. J Hand Surg 2000; 25A: 899-910.
• Moriya T, Aoki M, Iba K,  et al. Effect of triangular ligament tears on distal radioulnar joint instability and evaluation of three clinical tests: a biomechanical study. J Hand Surg. (European Vol) 2009; 34E:2:219-223.
• Moskal MJ, Savoie FH, Field LD. Arthroscopic capsulodesis of the lunatotriquetral joint. Clin Sports Med 2001; 20:141-153.
• Mueller LP, Mueller LA, Degreif J, Rommens PM. Hypothenar hammer syndrome in a golf player. Am J Sports Med 2000; 28:741-45.
• Nagle DJ. Triangular fibrocartilage complex tears in the athlete. Clin Sports Med. 2001;20:155-65.
• Nakamura K, Beppu M, , Patterson RM, Hanson CA, Hume PJ, Viegas SF. Motion analysis in two dimensions of radial-ulnar deviation of Type I versus Type II lunates. J Hand Surg 2000; 25A: 877-888.
• Nakamura K, Patterson RM, Moritomo H, Viegas SF. Type I versus Type II lunates: Ligament anatomy and presence of arthrosis. J Hand Surg 2001; 26A: 428-436.
• Nakamura T et al. Radial styloidectomy: A biomechanical study on stability of the wrist joint. J Hand Surg 2001; 26-A: 85-93.
• Nakamura T, Cooney WP, Wai-Hee L, Haugstevedt J-R, Zhao KD, Berglund L, An K-N. Radial styloidectomy: A biomechanical study on stability of the wrist joint. J Hand Surg. 2001; 26A:85-93.
• Nayak SR, Krishnamurthy A, Prabhu LV, Rai R, Ranade AV, Madhyastha S. Anatomical variation of radial wrist extensor muscles: a study in cadavers. Clinics. 2008;63(1):85-90.
• Neu CP, Crisco JJ, Wolfe SW. In-vivo kinematic behavior of the radiocapitate joint during wrist flexion-extension and radio-ulnar deviation. J Biomech 2001; 34:1429-38.
• Nicolaidis SC et al. Acute injuries of the distal radioulnar joint. Hand Clinics 2000; 16:449-59.
• Nigro RO. Anatomy of the flexor retinaculum of the wrist and the flexor carpi radialis tunnel. Hand Clin 2001; 1:61-64.
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• Rashid M, Sarwar SU, Haq EU, Islam MZ, Rizvi TA, Ahmad M, Shah K. Tuberculous tenosynovitis: a cause of Carpal Tunnel Syndrome. J Pak Med Assoc. 2006 Mar;56(3):116-8.
• Rossi C, Cellocco P, Margaritondo E, Bizzarri F, Costanzo G. De Quervain disease in volleyball players. Am J Sports Med. 2005 Mar;33(3):424-7.
• Satria O, Aprilya D, Hadinoto SA. Ulnar-Sided Wrist Pain: Systematic Clinical Approach and Principles of Treatment. Orthopedic Research and Reviews. 2025 Dec 31:199-212.
• Shin AY, Weinstein LP, Berger RA, Bishop AT. Treatment of isolated injuries in the lunatotriquetral ligament J Bone Joint Surg. 2001;83-B:1023-28.
• Silva A, Manso A, Andrade R, Domingues V, Brandão MP, Silva AG. Quantitative in vivo longitudinal nerve excursion and strain in response to joint movement: A systematic literature review. Clin Biomech (Bristol, Avon). 2014 Sep;29(8):839-847.
• Slutsky DJ. Arthroscopic dorsal radiocarpal ligament repair. Arthroscopy 2005; 21:1486 e1-e4.
• Smith TM, Sawyer SF, Sizer PS, Brismée JM. The double crush syndrome: a common occurrence in cyclists with ulnar nerve neuropathy-a case-control study. Clin J Sport Med. 2008 Jan;18(1):55-61.
• Sodha S, Ring D, Zurakowski D, Jupiter JB. Prevalence of osteoarthrosis of the trapeziometacarpal joint. J Bone Joint Surg Am. 2005 Dec;87(12):2614-8.
• Stuart PR, Berger RA, Linschied RL, An K. The dorsopalmar stability of the distal radioulnar joint. J Hand Surg. 2000; 25A:689-699.
• Tagliafico A, Rubino M, Autuori A, Bianchi S, Martinoli C. Wrist and hand ultrasound. Semin Musculoskelet Radiol. 2007;11(2):95-104.
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• Taljanovic MS, Sheppard JE, Jones MD, Switlick DN, Hunter TB, Rogers LF. Sonography and sonoarthrography of the scapholunate and lunotriquetral ligaments and triangular fibrocartilage disk: initial experience and correlation with arthrography and magnetic resonance arthrography. J Ultrasound Med. 2008;27(2):179-91.
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• Vaught MS, Brismée JM, Dedrick GS, Sizer PS, Sawyer SF. Association of disturbances in the thoracic outlet in subjects with carpal tunnel syndrome: a case–control study. Journal of Hand Therapy. 2011 Jan 1;24(1):44-52.
• Villafañe JH, Silva GB, Bishop MD, Fernandez-Carnero J. Radial nerve mobilization decreases pain sensitivity and improves motor performance in patients with thumb carpometacarpal osteoarthritis: a randomized controlled trial. Arch Phys Med Rehabil. 2012 Mar;93(3):396-403.
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• Wolfe SW, Neu C, Crisco JJ. In-vivo scaphoid, lunate, and capitate kinematics in flexion and extension. J Hand Surg 2000; 25-A:860-9.
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