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足蹬外旋复位法治疗肩关节前脱位的病例对照研究
Hits: 2558   Download times: 1276   Received:March 27, 2011    
作者Author单位UnitE-Mail
马永刚 MA Yong-gang 武汉大学人民医院骨科,湖北 武汉 430060 Department of Orthopaedics, People's Hospital Affiliated to Wuhan University, Wuhan 430060, Hubei, China martin1354@163.com 
李亚明 LI Ya-ming 武汉大学人民医院骨科,湖北 武汉 430060 Department of Orthopaedics, People's Hospital Affiliated to Wuhan University, Wuhan 430060, Hubei, China  
周小锐 ZHOU Xiao-rui 武汉大学人民医院骨科,湖北 武汉 430060 Department of Orthopaedics, People's Hospital Affiliated to Wuhan University, Wuhan 430060, Hubei, China  
张弩 ZHANG Nu 武汉大学人民医院骨科,湖北 武汉 430060 Department of Orthopaedics, People's Hospital Affiliated to Wuhan University, Wuhan 430060, Hubei, China  
期刊信息:《中国骨伤》2011年24卷,第11期,第915-917页
DOI:10.3969/j.issn.1003-0034.2011.11.010


目的:介绍足蹬复位法(Hennipen)外旋治疗肩关节前脱位的特点及其临床疗效。

方法:2007年3月至2010年3月采用Hennipen外旋法治疗肩关节前脱位28例(Hennipen组),男17例,女11例;年龄21~72 岁,平均(39.2±5.1)岁;其中喙突下脱位8例,盂下脱位16例,锁骨下脱位4例。同期采用足蹬法复位法治疗肩关节前脱位44例(Hippocratic组),男32例,女12例;年龄15~68 岁,平均(36.8±3.4)岁;其中喙突下脱位12例,盂下脱位29 例,锁骨下脱位3例。所有患者均根据临床表现和肩关节X线片确诊,手法复位后行搭肩位肘胸绷带固定3~4周。比较两组患者复位过程、并发症及功能恢复情况(采用UCLA肩关节功能评分标准).

结果:Hippocratic组复位操作在2~5 min完成[平均(3.9±1.2) min],其中32例接受静脉麻醉;Hennipen组复位操作在0.5~2 min完成[平均(1.3±0.7) min],3例患者需在麻醉下复位;两组复位时间差异有统计学意义(P<0.05).Hippocratic组1例老年患者复位过程中发生肱骨大结节撕脱骨折,1例发生肋骨骨折;Hennipen组无明显并发症发生。复位3~4周后随访,Hippocratic、Hennipen组患者肩关节UCLA评分分别为(34.2±2.1)分和(33.8±1.6)分,差异无统计学意义(P>0.05).

结论:足蹬法复位法和Hennipen外旋法治疗肩关节前脱位均能获得良好的疗效,但Hennipen外旋法操作简单,并发症少,尤其适于急诊复位操作。
[关键词]:肩关节  脱位  手法复位  病例对照研究
 
Case-control study on Hennipen external rotation procedure for reduction of 28 patients with acute anterior shoulder dislocation
Abstract:

Objective: To introduce the characteristics and its clinical effects of Hennipen external rotation procedure for reduction of acute anterior shoulder dislocation.

Methods: From March 2007 to March 2010, 72 patients with acute anterior shoulder dislocation were treated with manipulative reduction in our department. All the patients were divided into two groups:the Hippocratic group with 44 patients receiving regular Hippocratic procedure, and the Hennipen group with 28 patients receiving Hennipen external rotation procedure. Clinical manifestation and radiology were used to diagnose. After reduction procedures, external fixation was applied for another 3 to 4 weeks. The reduction course, complication and function recovery at follow-up were recorded and compared. The student test was used to analyze the difference between groups.

Results: Thirty-two patients in the Hippocratic group and 3 in Hennipen received intravenous anesthesia. Manipulation time of the Hippocratic group ranged from 2 to 5 minutes with a mean of(3. 9±1. 2) minutes, obviously different from that of Hennipen, which ranged from 0. 5 to 2 minutes with a mean of(1. 3±0. 7) minutes. Complications occurred in 2 cases of the Hippocratic group and none of the Hennipen group. The UCLA scores of shoulder joint at follow-up were 34. 2±2. 1 and 33. 8±1. 0 respectively in two groups, with no significant difference.

Conclusion: Compared with Hippocratic procedure, Hennipen external rotation procedure is easier to manipulate, bring less complications and the same effect. It is worth further clinical applications.
KEYWORDS:Shoulder joint  Dislocations  Manipulation, orthopedic  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:马永刚,李亚明,周小锐,张弩.足蹬外旋复位法治疗肩关节前脱位的病例对照研究[J].中国骨伤,2011,24(11):915~917
英文格式:MA Yong-gang,LI Ya-ming,ZHOU Xiao-rui,ZHANG Nu.Case-control study on Hennipen external rotation procedure for reduction of 28 patients with acute anterior shoulder dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(11):915~917
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