Department of Obstetrics and Gynaecology, North Manchester General Hospital, Manchester, UK.
Department of Trauma and Orthopaedics, Rotorua Hospital, Rotorua, New Zealand.
Br J Hosp Med (Lond). 2022 Apr 2;83(4):1-8. doi: 10.12968/hmed.2021.0309. Epub 2022 Apr 6.
Following dislocation of the glenohumeral joint with an isolated greater tuberosity fracture, closed reduction in the emergency department can lead to fracture propagation or iatrogenic fractures. This article assesses the evidence regarding when anterior dislocations of the shoulder with an isolated fracture of the greater tuberosity can be safely reduced in the emergency department, as there is currently no clear guidance on this. A total of eight articles described 172 cases which underwent closed reduction, which resulted in 22 cases of iatrogenic fractures. Female sex, increased patient age and fragments of the greater tuberosity were associated with an increased risk of iatrogenic fractures. Closed reduction in the emergency department appears to be a safe option in younger patients and those with greater tuberosity fractures less than 40% of the width of the humeral head.
肩盂肱关节脱位合并单纯大结节骨折后,在急诊科进行闭合复位可能导致骨折扩展或医源性骨折。本文评估了有关在急诊科安全地对肩部前脱位伴单纯大结节骨折进行闭合复位的证据,因为目前对此尚无明确的指导意见。共有 8 篇文章描述了 172 例接受闭合复位的病例,其中 22 例发生了医源性骨折。女性、患者年龄增加以及大结节碎片与医源性骨折的风险增加有关。在年轻患者和大结节骨折小于肱骨头部宽度的 40%的患者中,急诊科的闭合复位似乎是一种安全的选择。