两种单人徒手复位治疗急性肩关节前脱位的临床疗效对比

Clinical efficacy of two therapies of single-operator manual reduction for acute anterior shoulder dislocation:a comparative study

目的比较两种单人徒手复位(外旋外展法与手牵足蹬法)治疗急性肩关节前脱位的临床疗效。方法将54例急性肩关节前脱位患者随机分为观察组与对照组,每组27例。观察组患者采用外旋外展法复位,对照组患者采用手牵足蹬法复位。比较两组患者的复位操作时间、复位时疼痛程度、复位后肩关节功能、复位成功率和并发症发生情况。结果观察组复位操作时间和复位时疼痛视觉模拟量表评分短于或低于对照组,差异有统计学意义(均P<0.05);观察组复位后肩关节美国加州大学肩关节评分量表评分和复位成功率均高于对照组,但差异无统计学意义(均P>0.05)。两组患者治疗过程中均无腋神经损伤、骨折等并发症发生。结论相较于手牵足蹬法,外旋外展法复位治疗急性肩关节前脱位复位操作时间更短,复位时疼痛程度更低,但复位成功率和复位后患者肩关节功能恢复情况是否更优仍有待进一步研究证实。

Objective To compare the clinical efficacy of two therapies of single-operator manual reduction(external rotation and abduction versus Hippocrates reduction)for the treatment of acute anterior shoulder dislocation.Methods Fifty-four patients with acute anterior shoulder dislocation were randomly divided into observation group(n=27)and control group(n=27).Patients in the observation group were treated with reduction with external rotation and abduction,and patients in the control group were treated with Hippocrates reduction.The duration of reduction manipulation,degree of pain during reduction,post-reduction shoulder joint function,success rate of reduction,and incidence of complications were compared between the two groups.Results The observation group yielded shorter duration of reduction manipulation and lower Visual Analogue Scale(VAS)pain score during reduction than the control group,demonstrating statistically significant difference between the two groups(all P<0.05);the observation group reported higher post-reduction scores on the University of California at Los Angeles Shoulder Rating Scale together with higher success rate of reduction than the control group,exhibiting no statistically significant difference between the two groups(all P>0.05).No treatment-emergent complications such as axillary nerve injury and fracture occurred in the two groups.Conclusion Compared with Hippocrates reduction,reduction with external rotation and abduction has shorter duration of reduction manipulation and lower pain degree during reduction in the treatment of acute anterior shoulder dislocation,but whether the success rate of reduction and the recovery of post-reduction shoulder joint function are better still needs further study to verify in the patients.