Tajima Kosuke, Nishida Yusho, Shimizu Chikako, Hori Shingo
Department of Emergency and Critical Care Medicine School of Medicine Keio University Tokyo Japan.
Department of Orthopedic Surgery Nasu Red Cross Hospital Otawara Japan.
Acute Med Surg. 2015 Dec 9;3(3):272-275. doi: 10.1002/ams2.179. eCollection 2016 Jul.
Forty-three male and 27 female patients with anterior shoulder dislocation, with an average age of 45 years, were treated with the "double traction method". The reduction is carried out by two operators, with the patient in a supine position. The first operator holds the patient's wrist and pulls gently longitudinally. After the patient's muscle spasm adequately subsides, the second operator tows the humerus head laterally by using a towel wrapped around the proximal arm.
Reduction was successful in 63 patients (90%). No iatrogenic fracture or neurovascular deficit occurred.
Movement of the patient's arm position causes pain-related muscle spasm. The double traction method is distinctive compared to other manual relocation maneuvers in that the patient's arm is kept at the same position throughout the whole procedure. This maneuver is an easy and safe reduction method for anterior shoulder dislocations, even for non-orthopedic surgeons. It should be an option worth considering for closed reduction in shoulder dislocations.
43例男性和27例女性前肩关节脱位患者，平均年龄45岁，采用“双牵引法”治疗。复位由两名操作人员进行，患者取仰卧位。第一名操作人员握住患者手腕并纵向轻轻牵拉。待患者肌肉痉挛充分缓解后，第二名操作人员用毛巾包裹上臂近端，向外牵引肱骨头。
63例患者（90%）复位成功。未发生医源性骨折或神经血管损伤。
患者手臂位置的移动会引起与疼痛相关的肌肉痉挛。与其他手动复位手法相比，双牵引法的独特之处在于在整个过程中患者的手臂保持在同一位置。这种手法对于前肩关节脱位是一种简单且安全的复位方法，即使对于非骨科医生也是如此。它应该是肩关节脱位闭合复位值得考虑的一种选择。
