FARES法与Hippocrates法手法复位治疗肩关节前脱位的对照研究

Comparison between FARES and Hippocrates method for reduction of acute anterior dislocations of the shoulder joints

目的比较快速、可靠、安全(FARES)法与Hippocrates法手法复位治疗肩关节前脱位的临床疗效。方法回顾分析2014年3月至2019年3月于上海长海医院骨科急诊就诊的106例肩关节前脱位患者的临床资料。依据复位方法将患者分为两组,A组54例采用FARES法复位,B组52例采用传统Hippocrates法复位。比较两组患者的复位成功率,复位操作时间,尝试复位次数,复位后并发症发生情况,疼痛的视觉模拟评分(VAS)。结果A组患者复位成功51例,成功率94.4%,B组复位成功42例,成功率80.8%,两组间存在差异(χ^2=2.496,P=0.039)。A组复位操作时间为(2.16±0.96)min,B组为(5.68±1.33)min,两组间存在差异(t=6.126,P=0.001)。复位过程中A组的疼痛VAS评分为(1.60±0.96)分,B组为(5.44±0.44)分,A组明显低于B组(t=6.461,P=0.000)。复位前与复位后两组的疼痛VAS评分无差异(P>0.05)。结论FARES法处理肩关节前脱位具有复位成功率高,时间短,安全性高,患者疼痛小的优势,是治疗肩关节前脱位较理想的方法,值得推广应用。

Objective To compare the clinical efficacy of Fast,Reliable,and Safe(FARES)method and Hippocrates method for reduction of anterior shoulder dislocation.Methods A retrospective review of 106 patients with anterior shoulder dislocations who visited our department from March 2014 to March 2019 was conducted,and were divided into two groups according to the reduction methods.Patients received the FARES method in the group A and the Hippocrates method in the group B.Patients′pain scores,reduction duration,success rate of the reduction methods,and complications were collected and compared.Results Fifty-one cases(94.4%)in the group A were successfully reduced,while 42 cases(80.8%)in the group B were successfully reduced,with statistically significant difference between the two groups(χ^2=2.496,P=0.039).Reduction duration in the group A was(2.16±0.96)min,and in the group B was(5.68±1.33)min,with significant difference(t=6.126,P=0.001).Pain VAS score during the reduction in the group A was(1.60±0.96),which was significantly lower than that in the group B[(5.44±0.44),t=6.461,P=0.000],but pain VAS score before and after reduction,no statistical difference was detected(P>0.05).Conclusion The FARES method is an ideal method for treatment of anterior dislocation of the shoulder joints due to its higher successful reduction rate,shorter reduction duration,and less pain,thus it should be advocated in the clinical application.