Momenzadeh Omid Reza, Pourmokhtari Masoome, Sefidbakht Sepideh, Vosoughi Amir Reza
Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Orthopedic Surgery, Jahrom University of Medical Sciences, Jahrom, Iran.
J Orthop Traumatol. 2015 Dec;16(4):317-21. doi: 10.1007/s10195-015-0348-9. Epub 2015 Apr 17.
The position of immobilization after anterior shoulder dislocation has been a controversial topic over the past decade. We compared the effect of post-reduction immobilization, whether external rotation or internal rotation, on coaptation of the torn labrum.
Twenty patients aged <40 years with primary anterior shoulder dislocation without associated fractures were randomized to post-reduction external rotation immobilization (nine patients) or internal rotation (11 patients). After 3 weeks, magnetic resonance arthrography was performed. Displacement, separation, and opening angle parameters were assessed and analyzed.
Separation (1.16 ± 1.11 vs 2.43 ± 1.17 mm), displacement (1.73 ± 1.64 vs 2.28 ± 1.36 mm), and opening angle (15.00 ± 15.84 vs 27.86 ± 14.74 °) in the externally rotated group were decreased in comparison to the internally rotated group. A statistically significant difference between groups was seen only for separation (p = 0.028); p values of displacement and opening angle were 0.354 and 0.099, respectively.
External rotation immobilization after reduction of primary anterior shoulder dislocation could result in a decrease in anterior capsule detachment and labral reduction.
在过去十年中，前肩关节脱位后的固定位置一直是一个有争议的话题。我们比较了复位后外旋或内旋固定对撕裂盂唇贴合的影响。
将20例年龄<40岁、原发性前肩关节脱位且无相关骨折的患者随机分为复位后外旋固定组（9例）和内旋固定组（11例）。3周后，进行磁共振关节造影。评估并分析移位、分离和开口角参数。
与内旋组相比，外旋组的分离（1.16±1.11对2.43±1.17mm）、移位（1.73±1.64对2.28±1.36mm）和开口角（15.00±15.84对27.86±14.74°）均降低。两组间仅分离有统计学显著差异（p = 0.028）；移位和开口角的p值分别为0.354和0.099。
原发性前肩关节脱位复位后外旋固定可导致前囊膜分离减少和盂唇复位。
