Objective： One of the most common joint dislocations presented to the emergency department （ED） is anterior shoulder dislocation （ASD）. Various techniques for the treatment of this abnormality have been suggested...Objective： One of the most common joint dislocations presented to the emergency department （ED） is anterior shoulder dislocation （ASD）. Various techniques for the treatment of this abnormality have been suggested. In this study, we evaluated the efficacy and success rate of modified scapular manipulation （MSM） as a painless procedure compared to traction-countertraction （TCT） for reduction of ASD. Methods： Patients with ASD who were presented to ED of Baqiyatallah Hospital, Tehran during 2011 were included. They were randomly divided into MSM group or TCT group and then pain at reduction, time of reduction, duration of hospitalization, and success rate were compared. In TCT group, reduction was performed using sedative and antipain medications. Results： Ninety seven patients （81.6% male） with a mean age of 34.15 years±13.48 years were studied. The reduction time between both groups showed a significant difference （470.88 seconds±227.59 seconds for TCT group, 79.35 seconds±82.49 seconds for MSM group, P〈0.001）. The success rate in MSM group in the first and second effort were 89% and 97% whereas 73% and 100% in the TCT group respectively （P〈0.001）. Conclusion： It seems that the manipulation technique can be more successful than the TCT method at the first effort whilst the second effort has the opposite results. Also MSM can be safer, cheaper and more acceptable for patients than TCT as a standard traditional method.展开更多
Objective: To evaluate the results of 36 unconstrained shoulder arthroplasties. Methods: In the series, 24 total and 12 hemi arthroplasties of the shoulders were performed with unconstrained shoulder prostheses in 29 ...Objective: To evaluate the results of 36 unconstrained shoulder arthroplasties. Methods: In the series, 24 total and 12 hemi arthroplasties of the shoulders were performed with unconstrained shoulder prostheses in 29 patients who suffered from glenohumeral degenerative arthritis, rheumatoid arthritis, avascular necrosis and proximal fracture of humerus, respectively. Follow up averaged 6.2 years. All patients were evaluated pre and post operatively using the rating system of the Society of American Shoulder and Elbow Surgeons which assesses the severity of pain, strength of muscles around shoulder, stability, range of motion and functional activities of daily living. Radiolucent line and migration of prostheses were observed postoperatively on X rays. Results: Postoperatively, the rate of pain relief was 91.3 %, and active range of motion increased by 47° in forward flexion, 43° in abduction , 30° in external rotation, and 4 segments in internal rotation. Preoperatively the average points of 6 functional activities patients could perform was 0.8 , and postoperatively 3.1 . On postoperative X ray, proximal migration of the humerus was seen in 8 shoulders, 6 of which had either a torn or absent rotator cuff. Radiolucent lines were seen around 1 humeral component and 9 glenoid components. One humeral and 2 glenoid components loosened. Conclusions: These results suggest that unconstrained shoulder arthroplasty is a satisfactory and safe technique.展开更多
文摘Objective： One of the most common joint dislocations presented to the emergency department （ED） is anterior shoulder dislocation （ASD）. Various techniques for the treatment of this abnormality have been suggested. In this study, we evaluated the efficacy and success rate of modified scapular manipulation （MSM） as a painless procedure compared to traction-countertraction （TCT） for reduction of ASD. Methods： Patients with ASD who were presented to ED of Baqiyatallah Hospital, Tehran during 2011 were included. They were randomly divided into MSM group or TCT group and then pain at reduction, time of reduction, duration of hospitalization, and success rate were compared. In TCT group, reduction was performed using sedative and antipain medications. Results： Ninety seven patients （81.6% male） with a mean age of 34.15 years±13.48 years were studied. The reduction time between both groups showed a significant difference （470.88 seconds±227.59 seconds for TCT group, 79.35 seconds±82.49 seconds for MSM group, P〈0.001）. The success rate in MSM group in the first and second effort were 89% and 97% whereas 73% and 100% in the TCT group respectively （P〈0.001）. Conclusion： It seems that the manipulation technique can be more successful than the TCT method at the first effort whilst the second effort has the opposite results. Also MSM can be safer, cheaper and more acceptable for patients than TCT as a standard traditional method.
文摘Objective: To evaluate the results of 36 unconstrained shoulder arthroplasties. Methods: In the series, 24 total and 12 hemi arthroplasties of the shoulders were performed with unconstrained shoulder prostheses in 29 patients who suffered from glenohumeral degenerative arthritis, rheumatoid arthritis, avascular necrosis and proximal fracture of humerus, respectively. Follow up averaged 6.2 years. All patients were evaluated pre and post operatively using the rating system of the Society of American Shoulder and Elbow Surgeons which assesses the severity of pain, strength of muscles around shoulder, stability, range of motion and functional activities of daily living. Radiolucent line and migration of prostheses were observed postoperatively on X rays. Results: Postoperatively, the rate of pain relief was 91.3 %, and active range of motion increased by 47° in forward flexion, 43° in abduction , 30° in external rotation, and 4 segments in internal rotation. Preoperatively the average points of 6 functional activities patients could perform was 0.8 , and postoperatively 3.1 . On postoperative X ray, proximal migration of the humerus was seen in 8 shoulders, 6 of which had either a torn or absent rotator cuff. Radiolucent lines were seen around 1 humeral component and 9 glenoid components. One humeral and 2 glenoid components loosened. Conclusions: These results suggest that unconstrained shoulder arthroplasty is a satisfactory and safe technique.
