Revue medicale suisse最新文献

Sport participation in Switzerland is steadily growing, with 8% sustaining injuries while practicing. Most popular sports include hiking, cycling, swimming, alpine skiing, and fitness. Thirty percent of shoulder injuries in urban areas are sport-related, mainly from football, cycling, and alpine skiing. Pathologies vary by arm movement : below horizontal (running, ice hockey), above the head (swimming), or throwing (handball). It is essential to differentiate biomechanical adaptations from actual injuries. This article summarizes common pathologies and highlights surgical management of less frequent but potentially disabling injuries.

Total knee arthroplasty (TKA) is one of the most performed orthopedic surgeries worldwide. For many years, TKA implants were positioned according to a systematic approach known as mechanical alignment, which prioritized implant survival over the restoration of a more physiological knee. A high dissatisfaction rate of 20% after knee prosthesis has led to a rethinking of coronal alignment and a move towards a more personalized approach. With improved instrumentation, new-generation implants and the advent of robotic surgery, it is now possible to better restore the patient's anatomy, to position implants more accurately and to optimize ligament balance in extension and flexion. The aim is to achieve greater patient satisfaction and the perception of a normal or forgotten knee after surgery, while preserving the long-term survival of implants.

Musculoskeletal diseases of the foot and ankle are common reasons for primary care consultations. The purpose of this article, which focuses on the seven most common foot and ankle pathologies seen in general practice, is to help general practitioners perform an initial radiological assessment that allows for a correct diagnosis and can then be used by the specialist without the need for repeat imaging. This approach optimizes collaboration between the general practitioner and the specialist, reduces costs, and avoids unnecessary patient radiation.

The development of chronic diseases and the aging of the population are increasing the demand for specialized nursing care in both outpatient and inpatient services. In 2019, the Sarine outpatient care service introduced a Clinical Nurse Specialist (CNS) to support the teams and management in systematically analyzing clinical practice. In some nursing homes, the INTERCARE model, developed by Advanced Practice Nurses (APNs), has been implemented. With specially trained nurses, this model has reduced unplanned hospitalizations and increased staff satisfaction. Advanced Nursing Practice (ANP) can add value to the Swiss healthcare system by meeting the rising demands in community health.

Clinical nurse specialists provide specialized care to individuals with complex health issues, while also supporting healthcare professionals and institutions in delivering evidence-based care. In hospital settings, they work at various levels within the organization: in a ward-based role. in transversal focused on specific issues such as pain management, and in the longitudinal follow-up of patients, ensuring continuity between hospitalization, outpatient care, and home care. With their clinical expertise deeply rooted in care environments and their systematic approach to practice improvement, clinical nurse specialists hold a unique position as key contributors within the healthcare system.

Nurse practitioners (NPs) have existed internationally for several decades, with scientific literature demonstrating improved access to care, patient safety, and well-being. To address the sociodemographic challenges of public health and the shortage of healthcare professionals, the Canton of Vaud was the first in Switzerland to develop a legal framework that defines the responsibilities and requirements of the NP role in order to integrate them into the healthcare system. The integration of NPs into the hospital setting has shown promising results. However, the lack of adequate financing models and federal standards is hampering the development of NPs, particularly in the community setting.