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matches the fan i i want us to oppose eyes for my bad english
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hope you will understand me i want to give a good uh a big
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thanks to boris and uh frederick for the invitation talk about these uh
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or not be able to its yell uh a reconstruction
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and it's still management in image sure uh athletes
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so has the stiffen say um my main activities
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knee is across copy so is also tree
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uh we know that a a is your web sure increase dramatically
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uh uh because of contribution of many competitions for a higher
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uh medical stuff there were uh and uh probably because m. arrive with on a more quickly
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and the scenes twenty years we have many many complication and we have
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many publication about a. c. l. in children and evolution of thinking
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so what is the problem the problem is that these a. c. in these in these viciously asian
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can be used diners and we will talk about dynasty specificity
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second problem with that is very seriously asian that can give
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instability miniskirt that match and inability to return to sport
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also we can't have early vision active change in children
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and adolescents with that kind of a hinge which
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and when we all can i said we we can also
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have been banned some gold disturbance somewhere ripped sure
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so that uh that quite a difficult problem or what happens basically city you have
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a high in an absentee to patient with format is the joint decision to
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crack the path fall as we say in france in a b. t. to continue
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activities and the the knees very painful and we have to know that
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uh there's a very low already yeah ability of clinical finding at this period
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x. ray very important that's basic that x. ray a low to do these
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very simple diners is is into a country that even on structure
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so that the average and the bony evolution of the a. c. l. and for many years
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uh this is a a mechanism was no have the only mode of a.
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c. rupture and you can see on that uh a table that uh
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eighty two percent of uh uh uh people to bonnie
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evolution oak you in school little miniature patients
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so weak straight first uh because of very good the bone on call is ligament and also
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we scattered age you can see some menus can uh some not many skeleton uh
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some uh common ground or some uh ligament this damage on this
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uh uh and this x. rays here uh a second fracture
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and uh uh to get connected on a a female argument evolution
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in c. p. c. l. evolution a. c. l. evolution on the top
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and many different uh allusion so we need these uh x-ray first of calls
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the exam of choice is an awry and enter i a low
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to make dynasty soft and cuddly and does a a rock show is
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the same sign as we have in adults that these rollover sensibility
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and low worse basically city you can see all these uh a very well known a sign now
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we have to know that fifty percent of entirely commenters easy rapture associated
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with many escalation so it's very important to check many excuse
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even if we are sure that we have a a true his ear
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rip sure we need to check me discuss on this inner eye
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uh by these uh image of double p. c. and all longitudinal t. are
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all these up in the obscene yell going open to the joint
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and sometime we have a a more dramatic damage like this uh
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a m. c. l. going inside the joint and we need a research we
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so we can say that uh according to the age we can
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have some uh uh uh uh a bony evolution uh before
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and uh i would say oh fourteen and between twelve to
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a eighteen and uh we have entirely given to structure
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that we know now that there's a side or a type of relation
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we scat imagine is even as a t. b. l. evolution
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which will sure and eight of agent you haven't normally x-ray and you have a
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catchy that years i haven't shouldn't was interact in or a specific sign
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uh that is uh an example of claim on is six
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years all the the c. joint diffusion try matches now
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very painful or uh you can see on x. ray normal x. ray but
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you have to sign on and ride the double p. c. l. sign
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another double here sign specific for very young children
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and these fried incarceration and uh uh the captive age you can see with these uh black arrow
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and if you don't make the diner this you have some classification occurring
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a few a day isn't a few we he's we're weeks uh after the primitive
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so we happen to publication about this you could type of probably sure
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so i as it is a barney or calculation is evolution
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uh we can repair that by actress copy using some specific way to have two hands free
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and you can that's i would check big that whatever many different technique exist
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for capital g. is uh i version it's a good uh a way to do it
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uh that's uh put out a laugh as uh you can see with these uh the script
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this read 'em with on the coptic on the cough take some don't tell your cortex
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uh it's uh uh uh putting down i'm uh i'm sure sure
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so in these bony happens and not acting as a design we have good resort because israel
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rate of miniskirt yeah there's low rate of residue laxity low rate of a rupture
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and of course we have some problems on rehabilitation program some risk of
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stiffness more if we had put some tension of on the ligament
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and um these uh type refer to a low to return to support very quickly
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that's the the bigger the big advantage compared to uh and try to get into
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scripture sorta speak about in trying to get into scripture in acute phase
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we now to do a uh only rehabilitation shorting organisation
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and and usually no sport in till uh the surgeon see the
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patient uh to discuss whatever we need surgery or not
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so what we know uh between the business to be in an airy can
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americans should we uh a boat uh uh the
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uh an unknown adaptive management um many of
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patient had and stability instability the k. word and instability can dig too it's the first
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tape of these that evolution wheeze many scale t. s. and early degenerative change
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we have a a only divinity of chandler user can feed these
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cases wrong or a rupture at thirteen and then after
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ten years you have the uh a very uh very bad
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knee with your antenna compartment uh a completely destroyed
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why it is evolution so bad uh probably because uh
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uh children have measure or joint a. p. laxity
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they have a jenna have high probability it's a one difficulties to treat these regular vitamin
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patient and children had by compliance to treatment
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and we know also they are daily people contact sport athletes
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so we are dealing with this many many uh uh um many scallop seals
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and we have to have a a a good experience in should during all these relation
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and even if they are uh the r. word so
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the walls complication of this isn't any security and
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you node yeah that's all of uh save the main discuss now very well uh um uh discuss
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so that's our rate of many scully isn't that time of
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surgery if we have one hundred seventy one knees
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and you can see that uh there is a a fifty five for um percent of a relation
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and that is mainly lays and in the posterior
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off a a segment of the main excuse
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equity on the miguel miscues and the latin manuscripts and you can see they're very rare regulation
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regulation other wars uh to switch or um and we have a few in
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children so that's a a good situation to have all these longitudinal lesion
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wherever we have done a reference to d. is published a few months ago
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in uh uh k. fifty out a boat rock collision or hide allusion
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uh when doing a systematic a prospective expiration throat intend options you
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we can see so um uh that was that the only reason i'm posting up to the
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miguel many screws was call a rock legion it's thirty three percent of round vision
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and it's much more than i did switch around the uh in fifty fifteen
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so i'm not a difficulty that many scale assessment in children and
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adolescents is there that we have a very little sensibility
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good space it's easy but little sensibility that mean that the clinic and exam often wrong
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b. nine is uh in children even if you have a uh a relation
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and we have to believe to these exam only when it's positive sign
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that's mean also that probably if we're doing a conservative
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management we would need to check many scripts with
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enter right on regularly uh batteries so when flap in fact in the committee's collision very important problem
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second problem can be uh the although diagnoses of many skull t. s. with these signal
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always inside the mean excuse the posterior all on of uh uh the major administers
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uh this is that's good after uh abnormality this is not a a t. out of the ministers so it's
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very important to know that because we have many patient reefer for many screw solution which is not
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so what about uh and how to commit to see if the allusion we have seen instability mean is guilty of
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the genetics and so probably we need for this patient with
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instability and all these need surgery to repair or
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and which kind of set required resets using hamstring button up won't and and and
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we have many different option we can maybe do we can do to the channel in
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different way we can have difference system of fixations some are more dangerous than over
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and and we have to take care about old is a different
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way to do um the procedure of is zero contraction
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whatever our option is using the uh quadriceps tendon with the ball unpacked allow her blog
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you can see here are we we have asked the is that we have
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a a and uh it is easier to nell under the sizes
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so we've done a lot that's to the to the state modifies is
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and we have a transitional tunnel on the on the t. v.
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so that's the way we do it exploration fast manuscript repair always
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and not pressed it's probably very important incident to take care about not actually are some not very narrow
00:11:58
so we need to to do not just press the in in children to probably to
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avoid we uh rip sure that's the artist in celebration of the bone brock
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we can use the floors cooked for uh the fame hard
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to know whether it's just behind the uh in a
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figured out how a collateral ligament you can see that you know just aren't the devices and the the
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tunnel to get is easy because it's a graphical trance easier
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and we can introduce the graph as you see
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that with the press feed fixation on the federal side
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a bone to bone a very uh very accurate
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and we have a double fixation on the t. v. yeah with this crew
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on the train and and this type of uh has a pasta fixation
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so what about rehabilitation in youngest it's uh sometime a difficult
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problem and we have some time on station d.
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to make some windows in the rehabilitation program because uh uh some
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i'm a strong rehabilitation some painful manoeuvre or uh some
00:13:00
all these uh and and bessie falls extension can
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can give some difficult situation and it's uh often uh important to have active
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nobody station and and self rehabilitation but by the the children himself
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uh about ready need the uh ability to sports um is it
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a question of the nice it's a question of test
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uh it's clear that before three months after sadly who have no problem because the patient is in uh
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uh is mine is uh in the mobility or coverage after
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six months become more difficult because the patient don't want
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to be limited to sports and it's important to say that good sensation and
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not the criteria to return to sport we need function up as
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and it's important to know that there's a biology there's really gonna
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deviation process and we have to wait around one hour
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one year for uh for one uh uh when the euro for
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for post operative care before return to or specific score
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so it's a reconstruction give good results objective objective
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row resort good result on ms got a
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heated good result of ms gives a protection that that the program these we ripped sure
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we speak about five percent of every picture now speak about
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ten and in the next symposium on the essay
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far will speak about probably more than twenty percent of
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uh we were sure so that's a real problem
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so what doubles uh the question of returning to sports
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i think we can say yes return to competition is possible or most of them will do
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that's returned to high level or competition very few of them will
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be able to a return to uh the highly ever
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so that the example of min and you with uh one of the best a gymnast in france and it should
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have been operate and she was able to return to to the same level but that's quite an exception
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so what about uh there was got grow disturbance so always speaking about
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grow disturbance when speaking about a few other conflicts and children
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um if the phase a device is closed or uh in central
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position around sixteen four boys and around fourteen forego also
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it's the hand of the grow it's adult time on that need so
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you can do added procedure and you don't have to care
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a boat to a dog world disturbance even defies easy easy visible on let it honey
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the risk of broad disturbance it's a real risk of course armrests that's the first type type a
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it's mainly due to technical for you can see here there's a a cash he
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um can agents prosecutor on the open grocery five this until
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you only you can see some screw throughout the plate
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uh on the same hand side so uh old these
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is usually the uh in a a bad the
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uh the bad technique uh uh uh and the the k. point is the uh federal location
00:16:15
uh i think that's an important point to discuss because uh we have some contradiction
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between a different uh uh i mean i'm sojourn about a t. adolescence
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uh at the adolescent is the more hunters area because the gross plate is not pushing anymore
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and we have some scroll girls plate and very easy to have a a growth i rest
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in a young children us more which can be break spontaneously because in young
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children to grossed like he's pushing a lot so we should not
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uh be confused between the risk and the comes to comes in order
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we have more risk and logan seconds in younger we have
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a a low risk and high come seconds so we have also like effect on roles we
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have over brawls they celebrated grows this is small effect with low to make an impact
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or make that can do that parents met must be aware
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about these boast percent or the basically this elevated persons
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so in experiment it it brought disturbance is really not a problem
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so what what about uh the isolation should be okay
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wait everybody the question is what happened there
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what happened to the patient we had no instability is there anyplace law conservative treatment i want
00:17:40
to say that conservative treatment is a cruel option it's not similar to nail abilities treatment
00:17:45
conservative treatment ease rehabilitation prop receptive protocol cross
00:17:51
for web returned to all sports
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are are able to do uh even people contact
00:17:57
sport without restriction without brace without clean
00:18:02
that they have to stock in case of instability they have
00:18:05
to be aware about the dungeon of conservative treatment
00:18:08
so is there any place probably in children without any instability probably in past a route you're
00:18:14
probably in the late or construction when we are very close to it's gonna tell majority
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and i'm probably not in high level athletes uh we
00:18:24
we have we have also a a pressure
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that they're not a low uh the place to to try
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the conservative treatment before uh going um uh had
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so that's what we are working on our conservative
00:18:39
treatment it's about a a fifty uh
00:18:43
um who sixty per show that haitian uh you can see in red patient operated
00:18:49
and you can see that a base and trade conservatively at ten am huh
00:18:55
so would that mean that before puberty puberty uh are not appear weak you
00:19:00
get ten yeah so we can see that some of them out
00:19:03
directed at ten or two of dentistry that mean that the purity is
00:19:08
the dandruff the rash of the a. c. l. management that
00:19:12
into it with a internet one face there's a good the a option for conservative treatment
00:19:19
so uh and in order to finish i want a just if you take a message yeah
00:19:24
uh and tried again to see if it works or dramatically increase that
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uh that's underestimate reason and that and that estimate uh on the diagnoses
00:19:35
point of view but also on the problems is point of view
00:19:39
um it's at three spatial not bad outcome because also daily sport athletes
00:19:45
lowered cellphones hyperactivity the old is uh uh get some problems
00:19:50
a conservative treatment perhaps only in selected cases
00:19:54
and and the clothes follow what we have to take care of a phantom ethics secondary many skull t. s.
00:20:00
probably conservative treatments it's not adapted for high level at that
00:20:05
and uh uh many scalp preservation is really a rule
00:20:09
and uh what about uh if yellow construction before maturity you can see that
00:20:14
many technique exist the ah we're yeah bro definitive it's not temporary method
00:20:20
and we have few brought disturbance in train uh units uh it gives a protection to ministers
00:20:26
and i cannot conclude without a word on on on prevention on sport accident we have
00:20:32
big talk yesterday and prevention and probably again to they would presents in a of this accident
00:20:39
just uh uh well uh again on in the unit seems to cells and fall
00:20:44
that's a man i uh opinion about management um
00:20:50
in and try with conservative treatment for us
00:20:54
and and if we haven't stability minutes does damage it
00:20:57
easier construction so the problem is not the age
00:21:00
the program is is the patient at and stability is the patient admin is good then at
00:21:06
if it's if it's on opens the file is easy needs of the easy scrolls position is surgery

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Conference program

Welcome
Frederic Koehn, President Young Athletes Forum Foundation
21 Sept. 2017 · 1:18 p.m.
3,136 views
Opening address
Boris GOJANOVIC
21 Sept. 2017 · 1:22 p.m.
131 views
Biological Maturation and the Path to Success: Before and After the Fact
Manuel COELHO-E-SILVA, Biological Maturation and the Path to Success: Before and After the Fact
21 Sept. 2017 · 1:31 p.m.
559 views
Designing pathways to success – part kaleidoscope, part microscope
Jason GULBIN, Designing pathways to success – part kaleidoscope, part microscope
21 Sept. 2017 · 1:53 p.m.
386 views
Talent ID and Development: Why doing the “right thing” is not always the “best thing
Ross TUCKER , Talent ID and Development: Why doing the “right thing” is not always the “best thing
21 Sept. 2017 · 2:16 p.m.
341 views
108 views
Resistance training during long-term athlete development
Urs GRANACHER
21 Sept. 2017 · 2:52 p.m.
366 views
The development of aerobic power in young athletes
Grégoire MILLET
21 Sept. 2017 · 3:15 p.m.
1,475 views
Fueling the young athlete
Asker JEUKENDRUP
21 Sept. 2017 · 3:36 p.m.
195 views
Training young athletes: challenges and opportunities
Marco CARDINALE
21 Sept. 2017 · 4:01 p.m.
183 views
TRAINING THE YOUNG ATHLETE - Q&A
Panel
21 Sept. 2017 · 4:33 p.m.
Coaching from junior to the top of the world (Lara Gut)
Patrick Flaction, Elitment
21 Sept. 2017 · 5:20 p.m.
195 views
Knee ligament injuries in immature athletes
Franck CHOTEL
22 Sept. 2017 · 7:48 a.m.
Osteochondral lesions
Franck ACCADBLED
22 Sept. 2017 · 8:11 a.m.
225 views
INJURIES WITH THE ORTHOPEDISTS - Q&A
Panel
22 Sept. 2017 · 8:54 a.m.
Back pain in young athletes
Liba SHEERAN
22 Sept. 2017 · 9:34 a.m.
Long term sequelae of youth overuse injuries
Mark BATT
22 Sept. 2017 · 10:19 a.m.
OVERUSE INJURIES - Q&A
Panel
22 Sept. 2017 · 10:40 a.m.
Concussions in young athletes : myths and reality
Christopher NEWMAN
22 Sept. 2017 · 10:52 a.m.
Screening for heart disease in sports – nonsense or necessary?
Matthias WILHELM
22 Sept. 2017 · 11:16 a.m.
Competitive Sport & Health: hidden issues
Gordon MATHESON
22 Sept. 2017 · 12:04 p.m.
Injury prevention programs : The 11+ Kids Project
Mario BIZZINI
22 Sept. 2017 · 2:12 p.m.
104 views
159 views
Parents’ Knowledge of Sport Psychology and Nutrition
Dr Camilla J. Knight
22 Sept. 2017 · 3:57 p.m.
Closing Address
Frederic Koehn, President Young Athletes Forum Foundation
22 Sept. 2017 · 6:04 p.m.

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