McNamara R M
Department of Emergency Medicine, Medical College of Pennsylvania, Philadelphia.
Ann Emerg Med. 1993 Jul;22(7):1140-4. doi: 10.1016/s0196-0644(05)80979-5.
This study examined the success rate, time required, technical ease, and reported patient discomfort for the use of scapular manipulation in the reduction of anterior shoulder dislocation. This study included a new variation of this technique using the seated position.
Prospective case series over a 19-month period.
The emergency departments of a university and a community hospital.
Patients with anterior shoulder dislocations.
Emergency medicine resident and attending physicians were instructed in the technique of scapular manipulation in a classroom setting and requested to use this method initially for the reduction of anterior shoulder dislocations. Premedication was at the physician's discretion.
There were 54 patients with 61 dislocations. Scapular manipulation was attempted by 19 residents and 12 attending physicians. The overall success rate of scapular manipulation was 79%, whereas that of physicians experienced with the technique was 86%. Of the successful reductions, 65% were performed in less than one minute, and physicians rated the technique as very easy or easy to perform in 74% of these cases. No premedication was used in 64% of the attempts at scapular manipulation, and these patients reported pain ratings similar to those of the premedicated groups. No complications were noted in this study.
Scapular manipulation generally is a simple, rapid, and reliable technique for the reduction of anterior shoulder dislocation.
本研究探讨了肩胛手法复位治疗肩关节前脱位的成功率、所需时间、操作难度以及患者报告的不适情况。本研究包括一种采用坐位的该技术新变体。
为期19个月的前瞻性病例系列研究。
一所大学和一家社区医院的急诊科。
肩关节前脱位患者。
在课堂环境中对急诊医学住院医师和主治医师进行肩胛手法复位技术培训，并要求他们最初使用该方法复位肩关节前脱位。是否进行预处理由医生自行决定。
共有54例患者发生61次脱位。19名住院医师和12名主治医师尝试了肩胛手法复位。肩胛手法复位的总体成功率为79%，而熟练掌握该技术的医生成功率为86%。在成功复位的病例中，65%在不到一分钟内完成，74%的病例中医生认为该技术非常容易或容易操作。64%的肩胛手法复位尝试未使用预处理，这些患者报告的疼痛评分与使用预处理的组相似。本研究未发现并发症。
肩胛手法复位通常是一种简单、快速且可靠的肩关节前脱位复位技术。
