[Neuromusculoskeletal disorders related to musical playing - a review of the literature]. / Les pathologies neuro-musculo-squelettiques en lien avec la pratique musicale. Une revue de la littérature.

The prevalence of pathologies associated with musical playing are high among professional musicians. While hearing injuries appear to be the most commonly disorder, instrumentalists are also prone to numerous neurological and musculoskeletal problems. Despite the increasing number of recent clinical studies, an appropriate identification of these problems by health practitioners remains difficult and the implementation of an adequate treatment is almost inexistent in a population of musicians with several disorders affecting the ability to play their instrument.

Les pathologies en lien avec la pratique musicale sont fréquentes dans une population de musiciens professionnels. Alors que les lésions auditives restent peut-être les seules connues du grand public, les musiciens sont aussi sujets à de nombreux troubles neurologiques et musculo-squelettiques. Malgré une augmentation récente des études cliniques, l'identification de ces troubles par les praticiens de la santé reste difficile et la mise en place de traitement est presque inexistante dans une population de musiciens présentant de nombreux troubles interférant avec la pratique de leur instrument.

[The syndrome of external ligament sprain in the horse]. / Le syndrome de l'entorse externe de la cheville.

The treatment of acute complete (grade III) tears of the lateral ligaments of the ankle has generated much controversy in the medical literature. Functional treatment has become the standard treatment as it has been shown that there is no significant difference in long term results whatever the treatment (operative repair and cast, cast alone, or early controlled mobilization). Functional treatment includes only a short period of protection by tape bandage or brace and allows early weight-bearing. Major trauma with avulsion of bone and severe ligamentous damage on both medial and lateral sides of the ankle is however an indication for surgical treatment in the acute phase. Secondary operative reconstruction can be performed in case of persistent instability and laxity of the ankle. Secondary anatomic repair as proposed by Brodström, Duquennoy et al. and Karlsson et al. has a high rate of success and avoids the potential morbidity of harvesting partially or totally the peroneus brevis or other tendon grafts. Evaluation of the injured ankle has improved and in selected patients ultrasonography, arthrography, magnetic resonance imaging or bone scintigraphy may be useful for further evaluation of the injury. The frequency of associated injuries has probably been underestimated. Although ankle sprain is often thought of as an injury involving only the lateral ankle ligaments, there are varied and multiple components to the common sprained ankle. This condition would perhaps more appropriately be designated as the sprained ankle syndrome.