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[1]李琳,李峰,陳華.肩胛固定旋復(fù)法治療肩關(guān)節(jié)前脫位[J].中醫(yī)正骨,2016,28(09):59-62.
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肩胛固定旋復(fù)法治療肩關(guān)節(jié)前脫位()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年09期
頁碼:
59-62
欄目:
臨床報道
出版日期:
2016-09-20

文章信息/Info

作者:
李琳1李峰2陳華2
1.湖北中醫(yī)藥大學(xué),湖北 武漢 430060; 2.湖北省中醫(yī)院,湖北 武漢 430074
關(guān)鍵詞:
肩脫位 正骨手法 肩胛固定旋復(fù)法
摘要:
目的:觀察肩胛固定旋復(fù)法治療肩關(guān)節(jié)前脫位的臨床療效和安全性。方法:2014年9月至2016 年3月,采用肩胛固定旋復(fù)法治療閉合性肩關(guān)節(jié)前脫位患者28例。男19例,女9例。年齡17~62歲,中位數(shù)37歲。左側(cè)11例,右側(cè)17例。原發(fā)性脫位20例,復(fù)發(fā)性脫位8例。合并肱骨大結(jié)節(jié)撕脫骨折5例,所有患者均無臂叢神經(jīng)損傷。喙突下脫位25例,盂下脫位3例。傷后至整復(fù)時間1~39 h,中位數(shù)3 h。23例單純脫位者,以前臂吊帶懸吊固定患肩于內(nèi)收內(nèi)旋位3~4周; 5例合并肱骨大結(jié)節(jié)撕脫骨折者,3例行經(jīng)皮空心釘固定術(shù)治療,2例予以超肩超肘石膏托固定患肩于內(nèi)收內(nèi)旋位3~4周。固定期間和固定解除后行患肢功能鍛煉。觀察復(fù)位成功、肩關(guān)節(jié)疼痛改善及并發(fā)癥發(fā)生情況,復(fù)位后3個月按照Neer肩關(guān)節(jié)評分標(biāo)準(zhǔn)評價療效。結(jié)果:所有患者均一次復(fù)位成功。復(fù)位時間32~110 s,中位數(shù)65 s。肩關(guān)節(jié)疼痛視覺模擬評分由復(fù)位前(7.7±0.3)分降至復(fù)位后(2.6±0.1)分。所有患者均獲隨防,隨訪時間4~12個月,中位數(shù)10個月。均無醫(yī)源性骨折、臂叢神經(jīng)損傷等并發(fā)癥發(fā)生。23例單純脫位者,22例療效評價為優(yōu),1例在劇烈活動中肩關(guān)節(jié)再次脫位; 5例合并肱骨大結(jié)節(jié)撕脫骨折者,療效評價4例優(yōu)、1例良。結(jié)論:采用肩胛固定旋復(fù)法治療肩關(guān)節(jié)前脫位,復(fù)位成功率高,能夠緩解肩關(guān)節(jié)疼痛,促進(jìn)肩關(guān)節(jié)功能恢復(fù),并發(fā)癥少,值得臨床推廣應(yīng)用。

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備注/Memo

備注/Memo:
2016-07-25收稿 2016-08-02修回
基金項目:湖北省中醫(yī)院院內(nèi)科研項目(JDZX2014Y27)
李峰 E-mail:[email protected]

更新日期/Last Update: 1900-01-01