Müller K H, Dingels W R
Aktuelle Traumatol. 1984 Jun;14(3):121-8.
The starting point of the retrospective analysis of 177 primary dislocations was the question of frequency of habitual dislocations, the correlation between habitual dislocation and time of early immobilisation, as well as the search for additional statements which would result in a differentiated therapy. 18.1% habitual dislocations were seen to develop, mostly after immobilisation for less than three weeks. It is an interesting fact that the technique of immobilisation made no difference. We found that after the first even there was generally no loss in function, whereas 14.5% of the men and 34.3% of the women complained of severe subjective symptoms. The 12 patients who underwent an operation because of habitual dislocation suffered neither from dysfunction nor from painful movement, and no dislocation was found. The rate of habitual dislocation in our patients showed a lower rate of dislocation of the shoulder joint. We found 18.1% dislocations, whereas the literature showed an average quota of 30%. To improve the results we recommend a special X-ray technique following the first reposition. In the age group between 20 and 30 years, which is most susceptible, we also recommend arthrography and arthroscopy of the shoulder joint. To improve typical lesions, such as osseous rupture of the capsule or what is known as Hill-Sachs lesions, primary operation is discussed as an alternative treatment.
对177例原发性脱位进行回顾性分析的出发点是习惯性脱位的发生率问题、习惯性脱位与早期固定时间的相关性，以及寻找能带来差异化治疗的其他因素。结果发现，18.1%的患者出现了习惯性脱位，大多发生在固定时间少于三周之后。有趣的是，固定技术并无差异。我们发现，即使在首次脱位后，一般也不会出现功能丧失的情况，然而，14.5%的男性和34.3%的女性抱怨有严重的主观症状。因习惯性脱位接受手术的12例患者既没有功能障碍，也没有疼痛性活动，且未发现脱位情况。我们患者中的习惯性脱位发生率显示肩关节脱位率较低。我们发现脱位率为18.1%，而文献显示平均比例为30%。为了改善治疗效果，我们建议在首次复位后采用特殊的X线技术。在最易患病的20至30岁年龄组中，我们还建议进行肩关节造影和关节镜检查。为了改善典型病变，如关节囊的骨性破裂或所谓的希尔-萨克斯损伤，讨论将一期手术作为替代治疗方法。
