FARES法治疗肩关节前下脱位合并肱骨大结节骨折

FARES method in treatment of anterior shoulder dislocation complicated by greater tuberosity fracture

[目的]评价Fares法与Hippocrates法治疗肩关节前脱位合并肱骨大结节骨折的疗效。[方法]采用回顾性研究方法,选取2007年3月-2015年12月因肩关节前脱位合并肱骨大结节撕脱骨折患者60例,其中男36例,女24例,手法复位分为FARES法治疗组与传统Hippocrates法治疗组,其中Fares法治疗组32例,传统Hippocrates组28例。对比分析两组患者复位时主观疼痛感觉、复位成功率、平均复位操作时间、复位后并发症等,并基于CT扫描评估肱骨大结节骨折块的位置。[结果]FARES复位法可更有效放松患者紧张肌群,减轻复位时痛苦,VAS评分明显低于Hippocrates组（P〈0.05）;Fares法复位成功率93.75%（30/32）显著高于Hippocrates法的75%（21/28）（P〈0.05）;FARES法复位平均操作时间3.07 min明显短于Hippocrates法的5.45 min（P〈0.05）;并且复位术后并发症发生概率亦明显低于Hippocrates组（P〈0.01）;两种方法复位后其肱骨大结节骨折块移位距离差异无统计学意义（P〉0.05）,两者复位效果相当。[结论]FARES复位法可有效降低肩关节脱位合并肱骨大结节骨折复位时主观疼痛感,复位操作时间短、成功率高,复位后并发症发生率低;且复位后肱骨大结节骨折块位置与Hippocrates法相当。

[ Objective] To investigate lutcome of FARES and Hippocrates methods in the treatment of anterior shoulder dis- location complicated bygreater tuberosity fracture. [ Method ] A retrospective analysis was performed for 60 patients （36 male and 24 female patients） who experienced anterior shoulder dislocation complicated by greater tuberosity avulsion fracture from March 2007 to December 2015. According to the method of manual reduction, these patients were divided into FARES groupwith 32 patients and Hippocrates group with 28 patients. The subjective pain during reduction, rate of successful reduction, mean reduction time, and complications after reduction were analyzed and compared between the two groups, and CT scanwas performed to determine the location of greater tuberosity fracture blocks. [ Result ] The FARES method effectively relaxed the tense muscles and alleviated the pain during reduction, and the FARES group showed a significantly lower Visual Analogue Scale score than the Hippocrates group （P 〈 O. 05）. The FARES method had a significantly higher rate of successful reduction than the Hippocrates method [93.75% （30/32） vs 75% （21/28）, P 〈0,05 ]. ,The FARES method showed a significantly shorter mean reduction time than the Hippocrates method （3.07 min vs 5.45 mih, P 〈0.05 ）, as well as a significantly lower incidence rate of complications after reduction than the Hippocrates method （P 〈 O. 01 ）. There was no significant difference in the translocation distance of greater tuberosity fracture blocks between the two methods （ P 〉 0.05 ）, and the two methods had comparable reduction effects. [ Conclusion] In patients with anterior shoulder dislocation complicated by greater tuberosity frac- ture, the FARES method can effectively reduce subjective pain during reduction and has a short reduction time, a high success rate, and a low incidence rate of complications after reduction. The position of greater tuberosity fracture blocks ：after reduction achieved by the FARES method is comparable to that achieved by the Hippocrates method.