改良 Milch 技术对肩关节前脱位患者生活质量的影响。

Effect of Using the Modified Milch Technique on Quality of Life in Patients with Anterior Dislocation of the Shoulder Joint.

出版信息

Altern Ther Health Med. 2023 Jan;29(1):144-149.

Abstract

OBJECTIVE

To evaluate the effect of the Milch technique on quality of life (QoL) in patients with anterior dislocation of the shoulder joint.

METHODS

A total of 126 patients undergoing manual reduction for anterior dislocation of the shoulder in our hospital from January 2021 to January 2022 were prospectively enrolled in this study. The randomized number table method was used to divide patients into the study group (63 patients) and the control group (63 patients). The study group was treated with a modified Milch technique while the control group was treated with the Hippocratic method. Success rate and complications were compared to evaluate the effectiveness of manual reduction. Clinical assessment of shoulder function included the Constant-Murley Score and visual analog scale (VAS) before, during and after manual reduction.

RESULTS

The success rate of primary and secondary reduction in the study group was significantly higher than in the control group (87.30% vs 61.90, respectively; P = .001; 11.11% vs 25.40%, respectively; P = .038). The failure rate in the study group was significantly lower than in the control group (1.59% vs 12.70%, respectively; P = .015). The time required for reduction in the study and control groups was 58.87 ± 7.92 seconds and 93.09 ± 8.01 seconds, respectively; a significant difference (t = -24.113; P < .001). There was no statistically significant difference in VAS scores before and during reduction in the 2 groups. After reduction, VAS scores in the study group were significantly lower than in the control group (1.02 ± 0.01 vs 1.14 ± 0.26, respectively; P < .001). There were no significant differences in pain level, activities of daily living, joint range of motion or muscle strength between the 2 groups before and after reduction (P > .05). After reduction, health status, emotional function, mental health, physiological function, physiological function, physical pain, vitality and social function scores in the study group were significantly higher than in the control group (P < .05). There were 4 avulsion fractures and 2 humeral fractures in the control group; no complications occurred in the study group, with a significant difference (χ2 = 6.289; P = .012).

CONCLUSION

The Milch technique can improve the QoL in patients with anterior dislocation of the shoulder, and the success rate of the reduction is high.

摘要

目的

评估 Milch 技术对肩关节前脱位患者生活质量（QoL）的影响。

方法

本研究前瞻性纳入 2021 年 1 月至 2022 年 1 月在我院接受手法复位治疗的肩关节前脱位患者 126 例。采用随机数字表法将患者分为研究组（63 例）和对照组（63 例）。研究组采用改良 Milch 技术治疗，对照组采用 Hippocratic 法治疗。比较两组患者的复位成功率和并发症，以评估手法复位的效果。临床评估肩关节功能包括术前、复位时和复位后Constant-Murley 评分和视觉模拟评分（VAS）。

结果

研究组患者的初次复位成功率和再次复位成功率明显高于对照组（分别为 87.30%和 61.90%，P=0.001；11.11%和 25.40%，P=0.038）。研究组患者的复位失败率明显低于对照组（分别为 1.59%和 12.70%，P=0.015）。研究组和对照组患者的复位时间分别为 58.87±7.92 秒和 93.09±8.01 秒，差异有统计学意义（t=-24.113，P<0.001）。两组患者复位前后 VAS 评分差异无统计学意义。复位后，研究组患者的 VAS 评分明显低于对照组（分别为 1.02±0.01 与 1.14±0.26，P<0.001）。两组患者复位前后疼痛程度、日常生活活动、关节活动度或肌力差异无统计学意义（P>0.05）。复位后，研究组患者的健康状况、情绪功能、心理健康、生理功能、生理职能、躯体疼痛、活力和社会功能评分均明显高于对照组（P<0.05）。对照组患者发生 4 例撕脱骨折和 2 例肱骨骨折，研究组患者未发生并发症，差异有统计学意义（χ2=6.289，P=0.012）。