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一种减少肩关节前脱位的简易新方法:侧卧位技术。

An Easy New Method for Reducing Anterior Shoulder Dislocations: The Lateral Position Technique.

作者信息

Makihara Koichiro, Makihara Nobuhiko, Takegami Yasuhiko

机构信息

Department of Orthopaedic Surgery, Shizuoka Saiseikai General Hospital, Shizuoka, JPN.

Department of Orthopaedic Surgery, Makihara Orthopaedic Clinic, Kota, JPN.

出版信息

Cureus. 2025 Jul 26;17(7):e88803. doi: 10.7759/cureus.88803. eCollection 2025 Jul.

Abstract

Background Anterior shoulder dislocation is the most common dislocation that occurs in the human body, and reduction can still be a major challenge to the physician. Objectives To develop a new reduction technique called the lateral position maneuver (LPM) method (also known as the Makihara method), which is performed in a lateral position by a single physician without sedation. Methods Eighty-five patients with clinically and radiographically proven acute anterior shoulder dislocations were included. The LPM method was used for all the patients included in the study. The inclusion criterion was a traumatic anterior dislocation of the shoulder that presented within 24 hours of injury, including those with a greater tuberosity fracture or Bankart lesion. Patients with multiple traumas, Neers three- or four-part fractures, insufficient clinical data, neuropathy, and dislocations repaired by other methods were excluded. Ultimately, 13 shoulders (13 patients) were included in the study. Results Numerous reduction techniques for anterior glenohumeral joints exist, and the success rate for first-time anterior shoulder dislocations ranges from 70% to 90%. Most of these techniques required assistance and sedation during the procedure; however, our technique is easy to perform as we were able to achieve a closed reduction of acute anterior dislocation, requiring only a single physician to perform it without the use of sedation. Conclusions This study showed that there were no complications from the use of the LPM method (Makihara method) and that it is useful. The number of patients included in this study was small, but further additional studies are needed to confirm its efficacy.

摘要

背景 肩关节前脱位是人体最常见的脱位类型,复位对医生来说仍然是一项重大挑战。

目的 开发一种新的复位技术,称为侧卧位手法(LPM)法(也称为牧原法),由一名医生在侧卧位下进行,无需镇静。

方法 纳入85例经临床和影像学证实为急性肩关节前脱位的患者。本研究纳入的所有患者均采用LPM法。纳入标准为受伤后24小时内出现的创伤性肩关节前脱位,包括伴有大结节骨折或Bankart损伤的患者。排除多发伤、Neer三部分或四部分骨折、临床资料不足、神经病变以及采用其他方法复位的脱位患者。最终,13例肩部(13例患者)纳入研究。

结果 存在多种用于盂肱关节前脱位的复位技术,首次肩关节前脱位的成功率在70%至90%之间。这些技术大多在操作过程中需要辅助和镇静;然而,我们的技术易于实施,因为我们能够实现急性前脱位的闭合复位,仅需一名医生操作,无需使用镇静剂。

结论 本研究表明,使用LPM法(牧原法)无并发症,且该方法有用。本研究纳入的患者数量较少,但需要进一步的额外研究来证实其疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bd3/12378828/f54de1011ca9/cureus-0017-00000088803-i01.jpg

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