Strict Standards: Non-static method meta::valeur() should not be called statically in /home/docteurvs/www/extensions/get.php on line 259

Strict Standards: Non-static method meta::valeur() should not be called statically in /home/docteurvs/www/extensions/get.php on line 260

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Strict Standards: Non-static method meta::valeur() should not be called statically in /home/docteurvs/www/extensions/get.php on line 274

Strict Standards: Non-static method meta::valeur() should not be called statically in /home/docteurvs/www/extensions/get.php on line 274

Strict Standards: Non-static method meta::valeur() should not be called statically in /home/docteurvs/www/extensions/get.php on line 274

Strict Standards: Non-static method meta::valeur() should not be called statically in /home/docteurvs/www/extensions/get.php on line 274

Strict Standards: Non-static method meta::valeur() should not be called statically in /home/docteurvs/www/extensions/get.php on line 274

Strict Standards: Non-static method extension::js() should not be called statically in /home/docteurvs/www/extensions/get.php on line 279

Strict Standards: Non-static method meta::valeur() should not be called statically in /home/docteurvs/www/extensions/get.php on line 280

Strict Standards: Non-static method extension::css() should not be called statically in /home/docteurvs/www/extensions/get.php on line 294

Strict Standards: Non-static method menu::liste_menu_lien() should not be called statically in /home/docteurvs/www/extensions/get.php on line 315

Strict Standards: Non-static method menu::actif() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 24

Strict Standards: Non-static method menu::actif() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 88

Strict Standards: Non-static method menu::groupeActif() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 93

Strict Standards: Non-static method menu::actif() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 24

Strict Standards: Non-static method menu::actif() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 88

Strict Standards: Non-static method menu::groupeActif() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 93

Strict Standards: Non-static method menu::actif() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 24

Strict Standards: Non-static method menu::actif() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 88

Strict Standards: Non-static method menu::groupeActif() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 48

Strict Standards: Non-static method meta::valeur() should not be called statically in /home/docteurvs/www/extensions/get.php on line 379

Strict Standards: Non-static method meta::valeur() should not be called statically in /home/docteurvs/www/extensions/get.php on line 380

Strict Standards: Non-static method meta::valeur() should not be called statically in /home/docteurvs/www/extensions/get.php on line 381

Strict Standards: Non-static method meta::valeur() should not be called statically in /home/docteurvs/www/extensions/get.php on line 382

Strict Standards: Non-static method extension::css() should not be called statically in /home/docteurvs/www/extensions/get.php on line 387

Strict Standards: Non-static method menu::affichage() should not be called statically in /home/docteurvs/www/extensions/affichage/document_1.php on line 21

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 136

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

Strict Standards: Non-static method menu::listeMenu() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 205

Strict Standards: Non-static method go::lien() should not be called statically in /home/docteurvs/www/extensions/fonctions/menu.php on line 223

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Dupuytren Aponevrectomie Dr Berard à Rouen chirurgien de la main
Docteur

Clinique de l’Europe

4 rue Octave Crutel

76100 Rouen

Tél. : 02 32 18 13 85

Accès rapide aux différentes interventions

Virginie Berard
chirurgie esthétique reconstructrice et réparatrice à Rouen

Dupuytren aponevrectomie

Principes : la maladie de Dupuytren est liée à un épaississement d'une structure fibreuse située sous la peau de la paume de la main et des doigts. Cet épaississement s'accompagne d'une rétraction qui limite l'extension des doigts et peut infiltrer la peau.
Le traitement par aponévrectomie est indiqué en cas de bride sévère ou complexe, ou de récidive et consiste à enlever le tissu rétracté causant la maladie.

Deux types de cicatrices :
une cicatrice en zigzag sur le doigt atteint, refermée par des fils de suture (pour 15 j)
une cicatrice transversale dans la paume de la main qui doit être laissée ouverte. La cicatrisation se fait alors d'elle même avec des pansements réguliers pendant 3 sem.
L’intervention est suivie d’une période de rééducation de plusieurs semaines, en flexion (il faut fermer les doigts) et en extension (grâce à des attelles élastiques ou orthèses d’extension). Il faut étirer les cicatrices dans les semaines qui suivent l’intervention et porter par intermittence plusieurs fois par jour une attelle élastique qui tire sur les doigts opérés.

 

Anesthésie : anesthésie locorégionale (anesthésie du bras) (le plus souvent), dure 2-3 à 8 heures selon le produit utilisé et selon l’intervention.

 

Cicatrices : elles sont fermées avec des fils non résorbables, que l’infirmière doit enlever au bout de 15 jours. Situées dans la paume et à la face palmaire du/des doigt(s) opérés.


Suites postopératoires : hospitalisation ambulatoire (si un doigt atteint) hospitalisation de deux jours (si plusieurs doigt atteints). Pansements tous les deux jours par infirmière DE. pendant 3 à 4 semaines (protocole de pansement pour l’infirmière fourni), douches dès qu’il n’y a plus de pansement, au bout de 3 à 4 semaines. Douches possibles avec une protection imperméable. Douleurs rares et peu intenses, bien calmés par traitement antalgique habituel.
Arrêt de travail entre un mois et demi et trois mois (selon le travail effectué). Pas de sport pendant un mois et demi à trois mois selon le sport.
Prise en charge par l’Assurance Maladie : oui. Mutuelle.

>> Pour en savoir plus lire la fiche complète du Dr BERARD (prochainement en ligne).

Vos questions (prochainement en ligne).