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俯位改良Hippocrates法整复肩关节脱位
Hits: 2506   Download times: 361   Received:September 08, 2011    
作者Author单位UnitE-Mail
赵鸿声 ZHAO Hong-sheng 江汉大学附属医院骨科, 湖北 武汉 430015 Department of Orthopaedics, Affiliated Hospital of Jianghan University, Wuhan 430015, Hubei, China whzhs13387568878@163.com 
靖光武 JING Guang-wu 江汉大学附属医院骨科, 湖北 武汉 430015 Department of Orthopaedics, Affiliated Hospital of Jianghan University, Wuhan 430015, Hubei, China  
张建军 ZHANG Jian-jun 新疆博尔塔拉蒙古自治州人民医院骨科  
期刊信息:《中国骨伤》2012年25卷,第3期,第256-257页
DOI:10.3969/j.issn.1003-0034.2012.03.020


目的:探讨肩关节前脱位复位方法,评价俯位改良 Hippocrates 法治疗效果。

方法:1998年2月至 2011年4月,应用俯位改良 Hippocrates 法整复肩关节前脱位1 028例,男689例,女339例;年龄11~86岁,平均38.3岁;其中32例曾因Hippocrates 法复位失败;86例合并肱骨大结节撕脱性骨折。复位方法:患者取俯卧位,术者立于患侧,双手握患侧腕部,足蹬于患侧腋下(左侧脱位用右足,右侧脱位用左足),另一足立地支撑;复位时,双手持缓用力牵引腕部约半分钟,足蹬腋下加以对抗,并且逐渐由畸形位置变为外展、外旋及后伸位;牵引同时发挥足跟的杠杆支点作用进行收展时轻轻摇晃患肢并内旋外旋进行复位。

结果:1 027例患者1次复位成功,平均复位时间50 s;1例因合并肱骨外科颈骨折后行手术治愈。86例合并肱骨大结节撕脱性骨折中84例达到解剖复位或近解剖复位,2例较大骨片者复位后不稳定,行经皮克氏针内固定痊愈。按Neer评分:优1 012例,良15例。

结论:俯位改良 Hippocrates法整复肩关节脱位成功率高,复位时不需麻醉,患者痛苦少,费用低,复位时间短,易掌握值得广泛应用。
[关键词]:肩关节  脱位  俯卧位  整复脱位
 
Treatment of dislocation of shoulder with manipulation of proneposition modified Hippocrates method
Abstract:

Objective:To explore the method of reduction of anterior dislocation of shoulder joint,evaluate the clinical effects of proneposition modified Hippocrates methods.

Methods:From February 1998 to April 2011,1 028 patients,689 males and 339 females,with anterior dislocation of shoulder joint were treated with manipulation of proneposition modified Hippocrates methods. The average age was 38.3 years(ranged from 11 to 86 years). Thirty-two cases by Hippocrates method failure to reset success,86 cases combined with geater tuberosity tore of humerus.

Results:One thousand and twenty-seven example applications,it took average 50 s,1 case was cured due to a combination of humerus surgical neck fracture. Eighty-six cases combined with greater tuberosity tore of humerus,84 cases reached anatomical reattachment or nearly anatomical reattachment,2 cases of large bone pieces instability were reduced by percutaneous needle. According to Neer score,there are 1 012 excellent cases,15 good cases.

Conclusion:Proneposition modified Hippocrates method is better than Hippocrates. It has the advantage of anesthesia,lower expense,short replacement,less pain,easier to master,and worth applying widely.
KEYWORDS:Shoulder joint  Dislocation  Prone position  Reducing luxation
 
引用本文,请按以下格式著录参考文献:
中文格式:赵鸿声,靖光武,张建军.俯位改良Hippocrates法整复肩关节脱位[J].中国骨伤,2012,25(3):256~257
英文格式:ZHAO Hong-sheng,JING Guang-wu,ZHANG Jian-jun.Treatment of dislocation of shoulder with manipulation of proneposition modified Hippocrates method[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(3):256~257
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