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土耳其某单一中心 1076 例肩关节脱位的回顾性研究,旨在评估复位后放射学检查在发现临床显著骨折中的作用。

A Retrospective Study of 1076 Cases of Shoulder Dislocation at a Single Center in Türkiye to Evaluate the Role of Post-Reduction Radiography in the Detection of Clinically Significant Fractures.

机构信息

Department of Emergency Medicine, Ankara Bilkent City Hospital, Ankara, Turkey.

EDepartment of Emergency Medicine, Ankara Bilkent City Hospital,, Ankara, Turkey.

出版信息

Med Sci Monit. 2024 Aug 26;30:e944666. doi: 10.12659/MSM.944666.

DOI:10.12659/MSM.944666
PMID:39183471
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11363742/
Abstract

BACKGROUND The role of post-reduction radiography in patients with shoulder dislocation remains controversial. Therefore, this retrospective study of 1076 cases of shoulder dislocation at a single center in Türkiye aimed to evaluate the role of post-reduction radiography in the detection of clinically significant fractures. MATERIAL AND METHODS Patients with radiographically confirmed anterior shoulder dislocation were included in the study, and their demographic data, mechanism of injury, pre- and post-reduction radiograph readings, reduction method, and patient outcome were recorded. The study analyzed patients who had pre- and post-reduction anterior-posterior and axillary shoulder radiographs. RESULTS During the 44-month study period, a total of 1076 patients were examined, and their pre- and post-reduction radiographs were reviewed by an independent radiologist. Of these patients, 27 (2.6%) had a fracture on their pre-reduction radiographs, while 32 (3.1%) had a fracture on their post-reduction radiographs. The difference between the 2 groups was not statistically significant (P=0.142). The study found that patients who did not undergo a post-reduction radiograph spent an average of 106 min in the emergency department, while patients who had the radiograph and were discharged spent an average of 237 min. The hospital stay of patients who had the radiograph was also significantly longer (P<0.01). CONCLUSIONS Our study supports that routine use of post-reduction radiographs in all cases of anterior shoulder dislocation may not be necessary and could potentially expose patients to unnecessary radiation exposure and healthcare costs. Shortening the examination time in the emergency department by not taking a follow-up radiograph will help prevent overcrowding.

摘要

背景

在肩关节脱位患者中,复位后 X 线摄影的作用仍存在争议。因此,本研究回顾性分析了土耳其一家单中心的 1076 例肩关节脱位患者,旨在评估复位后 X 线摄影在发现临床显著骨折中的作用。

材料和方法

本研究纳入了经影像学证实的前向肩关节脱位患者,记录了他们的人口统计学数据、损伤机制、复位前后 X 线片阅读、复位方法和患者结局。本研究分析了具有前后位和腋位肩关节复位前后 X 线片的患者。

结果

在 44 个月的研究期间,共检查了 1076 例患者,由一名独立放射科医生对其复位前后 X 线片进行了评估。在这些患者中,27 例(2.6%)在复位前 X 线片上有骨折,32 例(3.1%)在复位后 X 线片上有骨折。两组之间的差异无统计学意义(P=0.142)。研究发现,未行复位后 X 线摄影的患者在急诊停留的平均时间为 106 分钟,而行 X 线摄影并出院的患者平均停留时间为 237 分钟。行 X 线摄影的患者的住院时间也明显延长(P<0.01)。

结论

我们的研究支持,在所有前向肩关节脱位病例中常规使用复位后 X 线摄影可能没有必要,并且可能使患者暴露于不必要的辐射和医疗保健费用之下。通过不进行随访 X 线摄影缩短急诊检查时间将有助于防止过度拥挤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0198/11363742/6231614a857e/medscimonit-30-e944666-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0198/11363742/1b6d4eabab37/medscimonit-30-e944666-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0198/11363742/6231614a857e/medscimonit-30-e944666-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0198/11363742/1b6d4eabab37/medscimonit-30-e944666-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0198/11363742/6231614a857e/medscimonit-30-e944666-g002.jpg

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A Retrospective Study of 1076 Cases of Shoulder Dislocation at a Single Center in Türkiye to Evaluate the Role of Post-Reduction Radiography in the Detection of Clinically Significant Fractures.土耳其某单一中心 1076 例肩关节脱位的回顾性研究,旨在评估复位后放射学检查在发现临床显著骨折中的作用。
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本文引用的文献

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Mechanisms of shoulder trauma: Current concepts.肩部创伤的机制:当前概念
World J Orthop. 2024 Jan 18;15(1):11-21. doi: 10.5312/wjo.v15.i1.11.
2
Frequency of Fractures Identified on Post-Reduction Radiographs After Shoulder Dislocation.肩关节脱位复位后X线片上发现的骨折频率。
West J Emerg Med. 2016 Jan;17(1):35-8. doi: 10.5811/westjem.2015.11.28855. Epub 2016 Jan 21.
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The role of post-reduction radiographs after shoulder dislocation.肩关节脱位复位后X线片的作用。
J Emerg Med. 2007 Aug;33(2):169-73. doi: 10.1016/j.jemermed.2007.01.003. Epub 2007 Jun 13.
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Survey of the management of acute traumatic first-time anterior shoulder dislocation among trauma clinicians in the UK.英国创伤临床医生对急性创伤性首次肩关节前脱位的管理调查。
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Anterior shoulder dislocations: beyond traction-countertraction.肩关节前脱位:超越牵引-对抗牵引法
J Emerg Med. 2004 Oct;27(3):301-6. doi: 10.1016/j.jemermed.2004.04.013.
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Anterior instability of the shoulder after trauma.创伤后肩关节前向不稳
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