Lee Kun-Han, Chang Shu-Hao, Hung Li-Wei
Department of Orthopedics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Department of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.
Sci Rep. 2025 May 30;15(1):18974. doi: 10.1038/s41598-025-04311-x.
Anterior shoulder dislocation is a common orthopedic emergency. While many reduction methods require sedation, the FARES (FAst, REliable, and Safe) and Spaso methods allow reduction without anesthesia. We conducted a single-center, prospective, randomized controlled trial comparing the FARES and Spaso methods for anterior shoulder dislocation reduction. Patients aged 20 to 90 years were enrolled. The assigned closed reduction procedures were performed without patient sedation by trained orthopedic residents. If two attempts with the assigned method failed, the alternative method was used. The primary outcome was the first-attempt success rate, while secondary outcomes included overall success rate with both methods, reduction time, and pain scores. During November 2013 and December 2015, a total of 32 patients were randomized to the FARES (n = 17) or Spaso (n = 15) method. The first-attempt success rates were 71.6% for the FARES group and 80.0% for the Spaso group (p = 0.691). Among patients with failed closed reduction using the first technique, all patients in the Spaso-following-FARES group achieved successful reduction, whereas none in the FARES-following-Spaso group achieved successful reduction (p = 0.092). Pain scores during reduction were comparable between the FARES (4.29 ± 1.69) and Spaso (3.80 ± 2.65) techniques, with no statistically significant difference (p = 0.542). Follow-up data were available for 28/32 patients (87.5%; mean 5.3 ± 2.2 years). Four patients were lost (3 FARES, 1 Spaso; p = 0.726). Recurrent dislocation occurred in 3 patients (10.7%; 1 FARES, 2 Spaso; p = 0.947), and 2 patients (1 per group; p = 0.876) underwent surgery (arthroscopic stabilization and rotator cuff repair). Both the FARES and Spaso methods were effective for reducing anterior shoulder dislocations. Combining these methods may improve overall reduction rates. Clinical trial registration: This trial was registered at ClinicalTrials.gov (Registration number: NCT01979237) on 08/11/2013.
肩关节前脱位是一种常见的骨科急症。虽然许多复位方法需要镇静，但FARES（快速、可靠且安全）法和Spaso法可在无麻醉的情况下进行复位。我们开展了一项单中心、前瞻性、随机对照试验，比较FARES法和Spaso法用于肩关节前脱位复位的效果。纳入年龄在20至90岁的患者。指定的闭合复位操作由经过培训的骨科住院医师在患者未镇静的情况下进行。如果使用指定方法尝试两次均失败，则采用另一种方法。主要结局是首次尝试成功率，次要结局包括两种方法的总体成功率、复位时间和疼痛评分。在2013年11月至2015年12月期间，共有32例患者被随机分为FARES组（n = 17）或Spaso组（n = 15）。FARES组的首次尝试成功率为71.6%，Spaso组为80.0%（p = 0.691）。在首次技术闭合复位失败的患者中，FARES法后采用Spaso法的所有患者均成功复位，而Spaso法后采用FARES法的患者均未成功复位（p = 0.092）。FARES技术（4.29±1.69）和Spaso技术（3.80±2.65）复位期间的疼痛评分相当，无统计学显著差异（p = 0.542）。32例患者中有28例（87.5%；平均5.3±2.2年）有随访数据。4例患者失访（3例FARES组，1例Spaso组；p = 0.726）。3例患者（10.7%；1例FARES组，2例Spaso组；p = 0.947）出现复发性脱位，2例患者（每组1例；p = 0.876）接受了手术（关节镜稳定术和肩袖修复术）。FARES法和Spaso法在复位肩关节前脱位方面均有效。联合使用这些方法可能会提高总体复位率。临床试验注册：本试验于2013年11月8日在ClinicalTrials.gov（注册号：NCT01979237）注册。
