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将肩部固定于外旋位以预防急性前脱位复发。

Immobilization of the shoulder in external rotation for prevention of recurrence in acute anterior dislocation.

作者信息

Taşkoparan Hüseyin, Kılınçoğlu Volkan, Tunay Servet, Bilgiç Serkan, Yurttaş Yüksel, Kömürcü Mahmut

机构信息

Department of Orthopedics and Traumatology, Gülhane Military Faculty of Medicine, Ankara, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2010;44(4):278-84. doi: 10.3944/AOTT.2010.2274.

DOI:10.3944/AOTT.2010.2274
PMID:21252604
Abstract

OBJECTIVES

We aimed to compare the functional and stability outcomes of the patients with acute anterior shoulder dislocation, who were stabilized at external versus internal rotation.

METHODS

A total of 33 patients (31 males and 2 females) with the diagnosis of acute primary traumatic anterior shoulder dislocation were immobilized at internal (n=17) or external rotation (n=16). The mean follow-up period was 20.85 months (range 6-41 months). Patients received rehabilitation program immediately after splinting. We assessed functionality by Constant-Murlay score and stability by Rowe scoring system in 6th month. Control examinations were performed in 12th and 24th months.

RESULTS

There were no statistically significant differences between internal rotation and external rotation groups in terms of Constant-Murlay and Rowe scores. Recurrent dislocation rate was 6.3% (1/16) in external rotation group and 29.4% (5/17) in internal rotation group (p>0.05). In the subgroup of patients aged between 21-30 years, while no recurrent dislocation was seen in external rotation group, 5 patients developed recurrent dislocation in internal rotation group(p=0.035).

CONCLUSION

Immobilization of the shoulder in external rotation is an effective technique for prevention of recurrent dislocations in acute anterior shoulder dislocation and should be preferred to traditional splinting in internal rotation in clinical practice.

摘要

目的

我们旨在比较急性前肩关节脱位患者在外旋与内旋位固定后的功能和稳定性结果。

方法

共有33例诊断为急性原发性创伤性前肩关节脱位的患者(31例男性,2例女性)被固定于内旋位(n = 17)或外旋位(n = 16)。平均随访期为20.85个月(范围6 - 41个月)。患者在夹板固定后立即接受康复计划。我们在第6个月通过Constant - Murlay评分评估功能,通过Rowe评分系统评估稳定性。在第12个月和第24个月进行对照检查。

结果

在内旋组和外旋组之间,Constant - Murlay评分和Rowe评分无统计学显著差异。外旋组复发性脱位率为6.3%(1/16),内旋组为29.4%(5/17)(p>0.05)。在年龄介于21 - 30岁的患者亚组中,外旋组未见复发性脱位,而内旋组有5例患者出现复发性脱位(p = 0.035)。

结论

将肩关节固定于外旋位是预防急性前肩关节脱位复发性脱位的有效技术,在临床实践中应优先于传统的内旋位夹板固定。

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