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Master Thesis

La prise en charge des périostites tibiales dans les armées françaises : étude de pratique professionnelle

Abstract : Medial tibial stress syndrome (MTSS) is a condition affecting the lower third of the inner part of the tibia and is related to overtraining. The military patient, due to the necessary duties in his profession, is particularly exposed to this type of injury. This condition takes a long time to progeress, ranging from one to three months. Currently no therapy has formally proven its effectiveness. We carried out an observational study of practice analysis addressed to the doctors within the French Army. It consisted in answering a questionnaire, in which the physicians had to express their opinion on various means of diagnostic and therapeutic management. We also determined a scoring system of the therapies ranging from 1 to 5. A total of 223 doctors responded to our study. The results showed that doctors tend not to order further test. When they do, it is to rule out a differential diagnosis. The examinations prescribed in the first place are: X-ray, then the MRI and the bone scan. On the therapeutic level, sports rest obtained the best score with 4.24. Then physiotherapy (score of 3.64), icing of the painful area (3.40), and shock waves (2.55) are the only therapies that obtained a score above the average. Most patients are seen again between two weeks and one month. Referral to a specialist is not uncommon and mainly concerns the rehabilitation doctor. Finally, respondents are particularly interested in setting up a sports recovery program adapted to this condition. This study shows that despite poor sensitivity and specificity, radiography is the first-line diagnostic method, which is probably linked to its ease of access. At the therapeutic level, apart from sports rest, no treatment is fully unanimous with the doctors of the Service de Santé des Armées Forces. Nonetheless, physical therapy, icing the painful area, and shock waves seem to be interesting ways that require further study.
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Master Thesis
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Submitted on : Tuesday, November 9, 2021 - 2:40:53 PM
Last modification on : Wednesday, December 15, 2021 - 3:57:48 AM
Long-term archiving on: : Thursday, February 10, 2022 - 6:55:48 PM


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  • HAL Id : dumas-03420944, version 1



Thomas Issartel. La prise en charge des périostites tibiales dans les armées françaises : étude de pratique professionnelle. Médecine humaine et pathologie. 2021. ⟨dumas-03420944⟩



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