Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel.
Knee Surg Sports Traumatol Arthrosc. 2021 Jul;29(7):2338-2341. doi: 10.1007/s00167-020-06310-z. Epub 2020 Oct 8.
To prospectively compare the effectiveness of three methods for self-assisted shoulder reduction demonstrated using a smartphone video link.
Anterior shoulder dislocation is very common among young adults. Patients often seek medical assistance in the emergency department to reduce their shoulder. Many techniques for shoulder reduction had been described, some of which do not require professional assistance and can be performed by patients themselves.
Patients admitted with anterior shoulder dislocation were randomized to either the Stimson, Milch or the Boss-Holtzach-Matter technique. Each patient was given a link to watch a short instructional video on his smartphone and instructed to attempt self-reduction. Success of the reduction, pain level, patient satisfaction and complications were recorded.
The study cohort consisted of 58 patients (mean age was 31.6 (18-66, median = 27), 82% males, 88% right hand dominant). Success rate using Boss-Holtzach-Matter (10 of 19, 53%) and self-assisted Milch (11 of 20, 55%) were significantly higher than with the self-assisted Stimson method (3 of 19, 16%), p < 0.05. Pain levels improved from 8.4 (2-10) to 3.1 (0-10) following the reduction. Patient subjective satisfaction from the reduction attempt was 6.7 (0-10). No complications were observed.
Both the Self-assisted Milch and the Boss-Holtzach-Matter techniques are ideal for reduction of anterior shoulder dislocation without medical assistance. Both methods can be successfully performed without assistance or previous education and taught using an instructional video.
Level II.
前瞻性比较三种使用智能手机视频链接辅助自行复位的方法的有效性。
年轻人中前肩脱位非常常见。患者通常在急诊室寻求医疗帮助以减轻肩部疼痛。已经描述了许多肩部复位技术，其中一些不需要专业帮助，患者可以自行完成。
将因前肩脱位而入院的患者随机分为 Stimson、Milch 或 Boss-Holtzach-Matter 技术组。每位患者都收到一个链接，可在其智能手机上观看简短的指导视频，并指导他们尝试自行复位。记录复位的成功率、疼痛程度、患者满意度和并发症。
研究队列包括 58 名患者（平均年龄为 31.6（18-66，中位数=27），82%为男性，88%为右手优势）。使用 Boss-Holtzach-Matter（19 例中的 10 例，53%）和自行辅助 Milch（20 例中的 11 例，55%）的成功率明显高于自行辅助 Stimson 方法（19 例中的 3 例，16%），p<0.05。复位后疼痛程度从 8.4（2-10）改善至 3.1（0-10）。患者对复位尝试的主观满意度为 6.7（0-10）。未观察到并发症。
在没有医疗帮助的情况下，自行辅助 Milch 和 Boss-Holtzach-Matter 技术都是前肩脱位复位的理想选择。这两种方法都可以在没有帮助或之前的教育的情况下成功完成，并可以使用教学视频进行教授。
2 级。
