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肩关节下脱位:三例采用“两步手法”复位的报告。

Inferior Shoulder Dislocation: A Report of Three Cases Reduced Using the 'Two-Step Manoeuvre'.

作者信息

Sam Jerry, Venkatesan Aakaash, Shah Rahul H, Rohra Satish R, Francis Leon

机构信息

Orthopaedics and Traumatology, Aneurin Bevan University Health Board, Newport, GBR.

出版信息

Cureus. 2024 Sep 9;16(9):e68982. doi: 10.7759/cureus.68982. eCollection 2024 Sep.

Abstract

Inferior shoulder dislocations are uncommon, accounting for a very small percentage of all shoulder dislocations. A reduction technique has been developed which involves a two-step process: the first involves converting the inferior dislocation into an anterior one and the second involves reducing the humeral head back into its anatomical position within the glenohumeral joint. Traditional methods, such as the overhead traction-counter traction technique, often require multiple attempts, the involvement of several medical professionals, and the use of significant sedation and analgesia, which can be more intensive for the patient. Inferior dislocations that are positioned beneath the coracoid process present a particular challenge. Although they might seem suitable for reduction using methods typically applied for anterior dislocations, their positioning is often too inferior for these techniques to be effective. This two-step reduction technique has been utilised successfully in sub-coracoid and sub-glenoid inferior shoulder dislocations. The method has proven advantageous as a single practitioner can perform it, usually requires only one attempt, involves minimal force, and can be done under conscious sedation. These benefits make it a valuable alternative to traditional approaches for reducing inferior shoulder dislocations.

摘要

肩关节下脱位并不常见,在所有肩关节脱位中所占比例极小。现已开发出一种复位技术,该技术包括两个步骤:第一步是将下脱位转变为前脱位,第二步是将肱骨头复位到盂肱关节内的解剖位置。传统方法,如过头牵引-对抗牵引技术,通常需要多次尝试,涉及多名医疗专业人员,并且需要使用大量镇静剂和镇痛药,这对患者来说可能更为痛苦。位于喙突下方的下脱位带来了特殊挑战。尽管它们似乎适合使用通常用于前脱位的方法进行复位,但它们的位置往往过低,这些技术无法有效发挥作用。这种两步复位技术已成功应用于喙突下和肩胛下肩关节下脱位。该方法已被证明具有优势,因为一名医生即可操作,通常只需一次尝试,用力极小,并且可以在清醒镇静下完成。这些优点使其成为传统肩关节下脱位复位方法的一种有价值的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86a7/11462781/f3d4068ed7b0/cureus-0016-00000068982-i01.jpg

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