Musculoskeletal diseases / Annals of Physical and Rehabilitation Medicine 57S (2014) e183–e201 e189 View metadata, citation and similar papers at core.ac.uk brought to you by CORE

J.M. Kim ∗, H.Y. Han , S.K. Kim A. Garch a, E.H. Kassimi b, K. Belhaj b, F. Lmidmaniprovidedb, by Elsevier - Publisher Connector The Catholic University of Korea, Incheon St. Mary’s Hospital, Incheon, Korea A. Elfatimi b ∗Corresponding author. a Service de traumatologie-orthopédie, Pavillon 32, CHU Ibn Rochd, Casablanca, Morocco b Keywords: Shoulder; Ultrasound; Cervical; Plain radiography Service de médecine physique et de réadaptation, CHU Ibn Rochd, Introduction.– Pain in the shoulder region is difficult to evaluation because it can Casablanca, Morocco ∗ originate from cervical spine or shoulder pathology. The purpose of the present Corresponding author. study is to usefulness of cervical plain radiography in treatment outcome of shoulder pain. Keywords: Foot; Lisfranc; Fracture; Rehabilitation Methods.– We examined all patients who had undergone radiologic evaluation Introduction.– The objective of this work is to clarify the therapeutic and pro- for cervical spine and ultrasound guided steroid injection for shoulder pain. gnostic characteristics of Lisfranc fracture dislocations, discuss the long-term Radiographic findings of the cervical spine were performed in all patients functional outcomes and rehabilitation care. and confirmed by a radiologist. Sex, age, duration of shoulder pain, range of Patients and methods.– Retrospective study of 11 cases treated conservatively motion of the shoulder, impingement sign, and pain by visual analog scale were and surgically and followed the service of rehabilitation between 2009 and 2012. measured. Results.– Nine cases were male. The average age was 37.3 years. Etiologies were Results.– Patients of shoulder pain with abnormal findings of cervical plain dominated by highway accidents. Orthopedic treatment was made in 3 patients radiography had poor treatment outcome than with normal findings of cervical by cast immobilization and surgical by internal fixation in 8 patients, followed spine. (P = 0.048) There were 21 patients with abnormal findings of cervical by a rehabilitation treatment in all patients. Complications were stiff ankle in plain radiography: 16 patients (53.3%) had abnormal findings of the cervical one case and atrophy of the triceps surae in one case. The functional results were spine in C5–6 level. Thirteen patients (61.9%) had supraspinatus tendinopathy satisfactory in 9 cases. with cervical spine pathology. Discussion.– The Lisfranc fracture dislocations occur in young adults during a Discussion.– In this study, shoulder pain patients with abnormal findings of violent shock. The diagnosis is based on radiographs and CT. Obtaining a stable cervical plain radiography have poor treatment outcome. Therefore, shoulder and permanent anatomical fixation guarantees the long-term functional outcome. pain patients should be evaluated cervical spine when they are not treated with Rehabilitation is essential, is based on the analgesic therapy, stretching, static conventional treatment. muscle contractions and the work of proprioception and posture. http://dx.doi.org/10.1016/j.rehab.2014.03.684 http://dx.doi.org/10.1016/j.rehab.2014.03.686

P085-e P087-e Painful shoulder in primary care patients Epidemiological and etiological profile of ,∗ P. Marquez Rodriguez a , J. Segura Blazquez b, shoulder pain in physical medicine b c D. Rodriguez Molina , V. Sierra Gonzalez experience of physical medicine and a Instituto Canario de Ortopedia y Traumatología (ICOT), Las Palmas de Gran Canaria, Spain functional rehabilitation (CHU Ibn Rochd, b Centro de Salud Canalejas, Las Palmas de Gran Canaria, Spain Casablanca, Morocco) c Servicio de Rehabilitacion, Hospital de Gran Canaria Doctor Negrin, Las A. Nait Khachat , N. El Amrani , N.S. Diagne , Palmas de Gran Canaria, Spain S. Lahrabli , F. Lmidmani , A. El Fatimi ∗Corresponding author. CHU de Casablanca, Casablanca, Morocco

Introduction.– Shoulder pain is the third most common cause of musculoskeletal Keywords: Shoulder pain; Epidemiology; Physical medicine and rehabilitation consultation in primary care. Any pain or disability in it, affects a person’s ability Objectives.– Identify painful pathologies of the shoulder and describe their to carry out daily activities. Our study determines in a period of time from epidemiological characteristics during an ambulatory activity of physical and October 2011 to September 2012 in a Primary Care Centre of Gran Canaria; rehabilitation medicine over a period of year. the number of adults consulting painful shoulder (non traumatic, non related to Methods.– This is a retrospective study of the records of patients treated between malignant diseases or inflammatory diseases), its distribution and management July 2012 and July 2013 for painful shoulder in a consultation of physical of them. and rehabilitation medicine of CHU of Casablanca (Morocco). We studied the Methods.– Observational, descriptive and retrospective study was designed. The epidemiological and the clinical parameters. data was collected from the electronic clinical registries. Results.– Of 1098 consultants, 91 patients consulted for painful shoulder (8, Results.– Nine hundred and two cases, 333 (36.9%) men, 569 (63.1%) women, 28%), the average age of patients was 54 years, with a female predominance. with an average age of 58 (95% CI.) The most common diagnosis was codified the most frequent pathologies were tendinopathy of the rotator cuff and adhesive as unspecified shoulder pain 91% followed by rotator cuff tendinitis 5.5% and capsulitis. The mean disease duration was 5 months. Analgesics are prescribed 0.7% calcific tendonitis. All cases were firstly managed by GP and 32.4% were in almost all cases, the number of rehabilitation sessions and the number of referred to specialists. infiltration was different depending on the etiology. Discussion.– The importance in primary care due to its prevalence, of a good Discussion.– Shoulder pain is a common reason for consultation in physical diagnosis and treatment of the principal shoulder pathology (frozen shoulder, medicine; it is usually associated with pathology of the rotator cuff or adhesive rotator cuff disorder, gleno-humeral joint arthritis and instability), to avoid capsulitis. Systematic scrutiny and allows to reach a lesion diagnosis allowing chronicity and complications. Management should be multidisciplinary, includ- proper care is taken. ing analgesics, relative rest and access to rehabilitation programs. http://dx.doi.org/10.1016/j.rehab.2014.03.687 http://dx.doi.org/10.1016/j.rehab.2014.03.685

P088-e P086-e Functional results of treatment of Management of Lisfranc fracture Volkmann’s contracture: A series of 19 cases dislocation: A series of 11 cases H. El Hyaoui a,∗, T. Toua a, N. El Koumiti a, Y. Chahrane a, ,∗ H. El Hyaoui a , N. El KoumitI a, T. Toua a, A. Messoudi a, S. Fnini a, A. Garch a, K. Belhaj b, M. Sirajelhak a, A. Messoudi a, J. Hassoun a, M. Arssi a, E.H. Kassimi b, F. Lmidmani b, A. Elfatimi b a Service de traumatologie-orthopédie, Pavillon 32, CHU Ibn Rochd, Casablanca, Morocco e190 Musculoskeletal diseases / Annals of Physical and Rehabilitation Medicine 57S (2014) e183–e201 b Service de médecine physique et de réadaptation, CHU Ibn Rochd, C. Charley a,∗, M.J. Launay b, E. Allart a, V. Durlent b Casablanca, Morocco a Hôpital Swynghedauw, CHRU de Lille, Lille, France ∗Corresponding author. b Hôpital Wattrelos, Lille, France ∗Corresponding author. Keywords: Volkmann’s contracture; Forearm; Surgery; Rehabilitation Purpose.– The aim of our work is to point out this serious pathology related our Keywords: Chronic low back pain; Clinically acceptable pain threshold; experience of treatment. Disability; Fears and beliefs; VAS pain Methods.– A retrospective series of 19 cases of average age 24 years with a male Goal.– Chronic low back pain patients presenting acceptable pain threshold predominance, 72% of rural origin. Fracture of two bones of the forearm was the (VASpain< 40 mm) ask for take-over. Why do these patients seem to suffer initial lesion in 8 cases and Jbira the direct cause in the genesis of the syndrome more from disability than pain? in 12 cases. We met 9 cases at the beginning stage for 10 cases sequelae stage. Methods.– Twenty-one low back pain patients presenting a VASpain< 40 and For the beginner stage Volkmann, attitude appealed to medical therapy alone in 46 ≥ 40. A comparative study of the variations of the Québec/VAS pain ratio 2 cases, fasciotomy in 5 cases, and amputation in 2 cases. For the sequelae stage and correlations between VAS pain, Québec scores and FABQ at the beginning, 4 surgical procedures were performed based on an extension of the muscles of at the end and a year after the program has been made. the anterior compartment of the forearm. Rehabilitation was made in all cases. Results.– The ratio Québec/VAS pain is different in the two subgroups at the Results.– We got 14 good results, 5 poor results. beginning of the program but is uniform after a year. Its evolution differs in both Discussion.– The best results were obtained for the beginner stage. However, a subgroups as it decreases significantly less for the less suffering patients. At the functional improvement was observed in all patients. Rehabilitation is essential beginning of the program, for the VAS< 40 mm group, the Québec score is only and had an important contribution to recover a sensitive and functional hand. correlated to FABQap. At the end and a year after the program, this correlation http://dx.doi.org/10.1016/j.rehab.2014.03.688 does not longer exist and the Québec score is only correlated to VASpain. Discussion.– VASpain< 40 patients present a disability correlated to fears and beliefs, regardless of the pain level. The program achieves a lasting correction of P089-e these psychological issues. This study allows one to discriminate a subpopulation Efficacy of extracorporeal shock wave of low back pain patients requiring potential cognitive behaviour therapy. therapy and ultrasound treatment in lateral http://dx.doi.org/10.1016/j.rehab.2014.03.690 epicondylitis: A prospective, randomized, controlled trial P091-e a,∗ b a a M. Vural , D. Diracoglu , B. Erhan , B. Gunduz , A case of acute calcific tendinitis of the G. Ozhan c, K. Pekedis c a gluteus medius Istanbul Physical Medicine and Rehabilitation Training Hospital, Istanbul, ∗ Turkey B. Aras , S. Kesikburun , Ü. Güzelküc¸ük , E. Yasar , b Istanbul Faculty of Medicine, Physical Medicine and Rehabilitation A.K. Tan Department, Istanbul, Turkey Gülhane Military Medical Academy, Department of Physical Medicine and c Rehabilitation, Turkish Armed Forces Rehabilitation Center, Ankara, Turkey Bakirkoy Dr Sadi Konuk Training Hospital, Istanbul, Turkey ∗ ∗Corresponding author. Corresponding author.

Keywords: Keywords: Lateral epicondylitis; Extracorporeal shock wave therapy; Gluteus medius; Calcific tendinitis; Hip pain Introduction. Therapeutic ultrasound – Calcific tendinitis is a benign inflammatory condition occurring Introduction.– Conservative treatment is usually primarily suggested for lateral in numerous anatomic locations. Involvement of the gluteus medius tendon is epicondylitis (LE) management. The aim of this study was to investigate the effi- uncommon. In this case, we report a patient with hip pain due to calcific tendinitis cacy of extracorporeal shock wave therapy (ESWT) compared with therapeutic of the gluteus medius tendon. Observations. ultrasound (US) in the treatment of LE. – A 39-year-old man was admitted to our outpatient clinic with Material and methods.– Ninety patients were enrolled. Visual Analogue Scale a severe right hip pain, exacerbating with activity, for 2 weeks. He had no his- (VAS) was used to assess pain. Maximal grip strengths (MGS) of the upper tory of trauma. Physical examination revealed marked tenderness over the right extremity were measured. Disability and symptoms were evaluated by the dis- greater trochanter. On plain radiography, a calcific deposit was seen adjacent to ability of the arm, shoulder and hand (DASH) questionnaire. Patients with LE the greater trochanter. MRI demonstrated inflammatory edematous changes in assigned randomly to one of three treatment groups -therapeutic US (group A), the insertion of the gluteus medius tendon to the greater trochanter. A diagnosis ESWT (group B), and control (group C). of acute calcific tendinitis was determined and the patient was treated conser- Results.– Statistically significant improvements were observed for VAS pain, vatively using nonsteroidal anti-inflammatory drugs. The patient reported no MGS, and DASH measured at immediately after treatment and 4 weeks after reduction in pain 1 week after the drug therapy. Consequently, a corticosteroid treatment according to baseline measures in 3 groups (P < 0.01). VAS pain and injection to the lesion site was administered. His symptoms decreased within 3 DASH measured at 4 weeks in group A and B were statistically significantly days. Discussion.– lower than control group (P < 0.05). No statistically significant difference was Clinicians should take into account the calcific tendinitis of the found at 4 weeks between group A and B (P > 0.05). gluteus medius in the differential diagnosis of hip pain. The diagnosis is based Discussion.– ESWT has similar efficacy with US and its shorter implementation on typical clinical and radiographic findings of calcific deposits in the corre- period can be an advantage for some patients. Further research is needed to sponding tendon. understand the long-term efficiency of these modalities. http://dx.doi.org/10.1016/j.rehab.2014.03.691 http://dx.doi.org/10.1016/j.rehab.2014.03.689 P092-e P090-e A case report of a symptomatic Rehabilitation programs: Handling osteopoikilosis patient ∗ take-over requests of chronic low back pain B. Aras , K. Aydemir , A. Uran , M.A. Taskaynatan , A.K. Tan patients presenting acceptable pain Gülhane Military Medical Academy, Department of Physical Medicine and threshold, by studying the relationship Rehabilitation, Turkish Armed Forces Rehabilitation Center, Ankara, Turkey between disability, pain and beliefs ∗Corresponding author.