Ugras Ali Akin, Mahirogullari Mahir, Kural Cemal, Erturk Ahmet Haldun, Cakmak Selami
Clinic of Orthopaedics and Traumatology, Haseki Training Hospital, Aksaray, Istanbul, Turkey.
J Emerg Med. 2008 May;34(4):383-7. doi: 10.1016/j.jemermed.2007.07.026. Epub 2008 Jan 28.
The Spaso technique consists of forward flexion, external rotation, and gentle traction for the reduction of anterior shoulder dislocations with the patient in the supine position. The aim of this prospective study was to assess clinical efficacy of the Spaso technique and to evaluate its complications. We prospectively evaluated 52 shoulder dislocations using the Spaso technique. All reductions were performed by residents in training. Rescue methods if initial reduction was unsuccessful were at the discretion of the treating physician. Fifty-two patients were enrolled and 39 (75%) dislocations were successfully reduced without anesthesia or assistance. The mean reduction time was 3.2 min, and 87% of successful reductions occurred in less than 5 min. If we exclude the first 20 cases as a learning period, the success rate increases up to 87.5%. There were no complications associated with using the Spaso technique in this series. Patients with concomitant greater tuberosity fractures and late presentation had a lower success rate, although this was not statistically significant. The Spaso method is effective in reducing anterior shoulder dislocations without anesthesia or assistance and may decrease reduction time and length of stay in the Emergency Department.
斯帕索（Spaso）技术包括在患者仰卧位时进行前屈、外旋和轻柔牵引，以复位肩关节前脱位。这项前瞻性研究的目的是评估斯帕索技术的临床疗效并评估其并发症。我们前瞻性地评估了使用斯帕索技术治疗的52例肩关节脱位。所有复位均由住院医师完成。若初次复位失败，补救方法由主治医生决定。纳入了52例患者，其中39例（75%）脱位在未使用麻醉或辅助的情况下成功复位。平均复位时间为3.2分钟，87%的成功复位在5分钟内完成。如果将前20例作为学习阶段排除在外，成功率可提高至87.5%。本系列中使用斯帕索技术未出现并发症。伴有大结节骨折和就诊较晚的患者成功率较低，尽管这在统计学上无显著意义。斯帕索方法在无需麻醉或辅助的情况下有效复位肩关节前脱位，且可能缩短复位时间和在急诊科的住院时间。
