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[一种治疗后锁型肩关节脱位的新复位技术。病例报告及技术描述]

[A new reduction technique for posterior locked shoulder dislocation. Case report and technique description].

作者信息

Godry H, Citak M, Königshausen M, Schildhauer T A, Seybold D

机构信息

Chirurgische Klinik und Poliklinik, BG-Universitätsklinikum Bergmannsheil, Ruhr-Universität, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland.

出版信息

Unfallchirurg. 2012 Aug;115(8):754-8. doi: 10.1007/s00113-011-2115-6.

Abstract

The case of a 61-year-old male with posterior dislocation of the right shoulder joint is presented and a new technique for closed reduction of posterior locked shoulder dislocation is described. The technique involves four steps: in step 1 a constant traction is applied on the injured arm, in step 2 the arm is internally rotated and in steps 3 and 4 the second arm of the physician is used as a lever arm to lateralize and ventralize the shoulder. Lateralization and ventralization of the humeral head are essential to engage the humeral head and to pass it around the glenoid during reduction. Steps 3 and 4 are performed simultaneously. In the presented case the patient suffered a traumatic shoulder dislocation with a rim fracture of the glenoid. After reduction the shoulder was stable and conservative treatment was performed. A 2 year follow-up examination revealed a pain-free and stable shoulder with free range of motion and an Oxford instability score of 48 points. The described reduction technique for posterior locked shoulder dislocation is a simple and gentle technique, which can be performed easily by one person.Presentation of a reduction technique for locked posterior shoulder dislocation. Constant traction and internal rotation is performed for engaging the locked humeral head. After disengaging the humeral head the reduction is performed by using the arm of the physician as a lever arm.

摘要

本文介绍了一例61岁男性右肩关节后脱位的病例,并描述了一种闭合复位锁定性肩关节后脱位的新技术。该技术包括四个步骤:第一步,对受伤手臂持续牵引;第二步,手臂内旋;第三步和第四步,术者的另一手臂作为杠杆臂使肩部外展和前屈。肱骨头的外展和前屈对于复位过程中使肱骨头嵌入并绕过关节盂至关重要。第三步和第四步同时进行。在该病例中,患者因创伤导致肩关节脱位并伴有关节盂边缘骨折。复位后肩部稳定,采取保守治疗。两年的随访检查显示,肩部无痛且稳定,活动范围正常,牛津不稳定评分为48分。所描述的锁定性肩关节后脱位复位技术简单且轻柔,一人即可轻松操作。介绍一种锁定性肩关节后脱位的复位技术。通过持续牵引和内旋使锁定的肱骨头嵌入。肱骨头脱离后,利用术者的手臂作为杠杆臂进行复位。

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