上举牵引内收复位法治疗肩关节脱位的临床分析

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1、上举牵引内收复位法治疗肩关节脱位的临床分析【摘要】［目的］探讨上举牵引内收复位法治疗肩关节脱位机制和效果。［方法］回顾性分析1997年1月～2007年8月期间治疗的68例肩关节脱位患者：男51例,女17例,年龄最小16岁,最大82岁,平均49岁。右肩关节脱位40例，左肩28例。均为外伤所致。其中车祸15例，跌伤32例，运动伤21例，分型为喙突下脱位40例,盂下脱位17例,锁骨下脱位6例，后脱位5例。其中复发性脱位17例,合并肱骨大结节撕脱骨折13例,臂丛神经损伤2例,肱骨外科颈骨折3例。伤后至整复时间最短30min,最长10

2、d,平均2.1d。采用上举牵引内收复位法对肩关节脱位患者进行复位。［结果］全部病例牵引时间30s～5min,均一次复位成功，经X线证实复位满意。本组中64例获得了6～24个月的随访，并进行疗效评定，治愈61例，好转3例。［结论］上举牵引内收复位法治疗成人肩关节脱位简便、易行,能有效避免继发性损伤,且符合肩关节解剖及生物力学原理,值得推广。【关键词】肩关节;脱位;复位Abstract：［Objective］Toexaminethemechanismandclinicaloutcomeofthetractionreduction

3、methodintreatingtheadultshoulderdislocation.［Method］FromJanuary1997toAugust2007,68patientsdiagnosedwithshoulderdislocationreceived10reductionwiththismethod.Aretrospectiveandobservationalstudyoftheoutcomeswasassessedinanumberofpatients.Therewerealtogether68patients

4、,51maleand17female,withanaverageageof49(rangingfrom16-82yearsold).Fortyofthecasesoccurredintherightshoulderand28othersintheleft,allcausedbytrauma:15intrafficaccidents,32byinjuriesfromfalls,and21bysportsinjuries.Fortyofthedislocationsliedundertheprocessuscoracoideus

5、,17undertheglenoid,6underthecollarboneand5postdislocation.Seventeenofthepatientshadrecurrentdislocation,13withnodulesavulsionfractureofthehumerus,2withbrachialplexusinjury,3withsurgicalneckofhumerusfractures.Theshortesttimeofrestorationafterinjurywas30minutes,andth

6、elongest10days,withanaverageof2.1days.［Result］Patientsthathadreceivedthereductionmethodfor30secondsto5minuteswereallrecoveredwithonetreatment,theresultbeingconfirmedbyXrays.Sixtyfourofthepatientswerefollowedupfor6-24monthsandtheclinicalresultswere:61curedand3turn

7、edtothebetter.［Conclusion］Thismethodiseasyandflexibleinthereductionofadultshoulderdislocation,withfewercomplicationsthanothertraditionalmethods.Itaccordswiththeshoulderanatomyandprinciplesofbiomechanics,anditis10suitabletopopularizing.Keywords：shoulderjoint;disloc

8、ation;reduction肩关节脱位是人体最常见的关节脱位之一,而又以前脱位为主。传统的前脱位整复方法有Hippocrates、Kocher法,但具有一定的暴力性,使用不当会造成腋窝部软组织或神经血管损伤。为此,自1997年1月～2007年8月,根据肩关节脱位的生物力学原理，笔者应用上