Stafylakis Dimitrios, Abrassart Sophie, Hoffmeyer Pierre
Department of Orthopedic Surgery and Traumatology, University Hospital of Geneva, Switzerland, Geneva, Switzerland.
J Emerg Med. 2016 Apr;50(4):656-9. doi: 10.1016/j.jemermed.2016.01.020. Epub 2016 Feb 15.
Anterior shoulder dislocation is a well-known injury for people working in emergency departments (EDs). Throughout the years, the focus has been shifted onto more gentle reduction techniques with less risk of iatrogenic injury, fracture displacement, and less pain for the patient. We present the results of one such technique, the Davos reduction maneuver, also known as the Boss-Holzach-Matter technique, as well as its advantages, disadvantages, and a few practical tips.
We evaluated, retrospectively, 100 patients presenting with an anteroinferior shoulder dislocation, who were treated in the ED of the university hospital of Geneva, Switzerland, in a time period of 18 months. In every case, the Davos technique was used for shoulder reduction. The detailed technique is described. Successful reduction was achieved in 86 patients. There were no neurological complications. Greater tuberosity fracture malreduction was noted in one case. Eighteen patients received no analgesia. Our results were comparable or superior to other reduction techniques.
We concluded that the Davos technique is an easy, nontraumatic, very well-tolerated, and most of all, safe way to reduce a shoulder. It is complication free and easy to apply, giving reproducible and comparable or superior results to other reduction techniques. At the same time, it is well tolerated by a compliant patient, which makes it an ideal first-time reduction technique for anterior shoulder dislocations.
对于在急诊科工作的人员来说,肩关节前脱位是一种常见的损伤。多年来,重点已转向采用更温和的复位技术,以降低医源性损伤、骨折移位的风险,并减轻患者的疼痛。我们展示了一种这样的技术——达沃斯复位手法(也称为博斯 - 霍尔扎赫 - 马特手法)的结果,以及它的优点、缺点和一些实用技巧。
我们回顾性评估了100例表现为肩关节前下脱位的患者,这些患者在18个月的时间段内在瑞士日内瓦大学医院急诊科接受治疗。在每种情况下,均采用达沃斯技术进行肩关节复位。详细描述了该技术。86例患者成功复位。无神经并发症。1例患者出现大结节骨折复位不良。18例患者未接受镇痛治疗。我们的结果与其他复位技术相当或更优。
我们得出结论,达沃斯技术是一种简单、无创、耐受性良好且最重要的是安全的肩关节复位方法。它无并发症且易于应用,与其他复位技术相比,能产生可重复且相当或更优的结果。同时,顺从的患者对其耐受性良好,这使其成为肩关节前脱位理想的首次复位技术。