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一种用于急性肩关节脱位的原始闭合复位技术:夹腕提肩法。

An original closed reduction technique for acute shoulder dislocation: the wrist-clamping and shoulder-lifting.

作者信息

Dai Wanwu, Liu Lei, Zong Shuang, Zhou Yong, Zheng Jun, Li Xingyan

机构信息

Department of Bone and Joint Surgery, Zhongxiang Hospital Affiliated to China Three Gorges University, Zhongxiang, 431900, Hubei, China.

Department of Bone and Joint Surgery, The Third Affiliated Hospital of Guangxi Medical University, Nanning, 530031, Guangxi, China.

出版信息

Int J Emerg Med. 2025 Mar 26;18(1):60. doi: 10.1186/s12245-025-00866-8.

Abstract

BACKGROUND

Acute anterior shoulder dislocation is one of the most common injuries in emergency medicine and orthopaedics. The aim of this study is to introduce a new closed reduction technique: the wrist-clamping and shoulder-lifting, for manual reduction of acute anterior shoulder dislocation.

PATIENTS AND METHODS

The patient is instructed to a sitting position, the doctor hold the wrist of the arm with both hands, slowly rotated the arm to 90-degree of abduction and 60-degree of external rotation with gentle strength. After the shoulder muscles were relaxed by continuous traction, the wrist of the arm was clamped with knee joints when the arm was in 45-degree of abduction and 60-degree of external rotation. Then place hands on axilla and lift shoulder upward until the reduction is complete.

RESULTS

Thirty-six dislocated shoulders were successfully reduced with this technique, without fracture and iatrogenic neurovascular complications. No sedation, anesthesia, or intra-articular injection were used in all patients. All reduction procedures were performed by a single operator without assistance, and meantime for reduction was 3 min (range 1-8 min).

CONCLUSIONS

The wrist-clamping and shoulder-lifting technique is a safe, simple, effective, gentle, fast and single-operator for anterior shoulder dislocations. Without sedation, anaesthesia, or intra-articular injection. This closed reduction technique enables orthopedists and emergency physicians to reduce the anterior shoulder dislocation smoothly and quickly, and provide a reliable and alternative reduction technique.

摘要

背景

急性前肩关节脱位是急诊医学和骨科最常见的损伤之一。本研究的目的是介绍一种新的闭合复位技术:夹腕提肩法,用于急性前肩关节脱位的手法复位。

患者与方法

患者取坐位,医生双手握住患侧手腕,轻柔缓慢地将患侧上肢外展至90°、外旋60°。持续牵引使肩部肌肉松弛后,当患侧上肢外展45°、外旋60°时,用膝关节夹住患侧手腕。然后将手置于腋窝处向上提拉肩部直至复位成功。

结果

采用该技术成功复位36例脱位肩关节,无骨折及医源性神经血管并发症。所有患者均未使用镇静、麻醉或关节内注射。所有复位操作均由一名术者独立完成,复位平均用时3分钟(1 - 8分钟)。

结论

夹腕提肩法治疗前肩关节脱位安全、简单、有效、轻柔、快速且可由单人操作,无需镇静、麻醉或关节内注射。这种闭合复位技术使骨科医生和急诊医生能够顺利、快速地复位前肩关节脱位,并提供了一种可靠的替代复位技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0662/11948627/7b811d8c9da0/12245_2025_866_Fig1_HTML.jpg

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