جستجوی مقالات مرتبط با کلیدواژه « دررفتگی شانه » در نشریات گروه « پزشکی »

Various methods have been designed for shoulder reduction and Kocher method (flexion, adduction and external rotation) and traction counter-traction are introduced as the oldest methods. Therefore, the present study was designed aiming to compare these two methods in reduction of anterior shoulder dislocation.
This quasi experimental study was conducted on 16 to 60 year-old patients presenting to emergency department following anterior shoulder dislocation during 1 year. Patients underwent reduction via Kocher or traction counter-traction methods and were compared regarding reduction time, pain relief rate, success rate and neurological vascular complications.
150 patients with the mean age of 32.11 ± 11.3 years were randomly divided into 2 groups of traction counter-traction (67 individuals) and Kocher (83 individuals) (86.7% male). The 2 groups were similar regarding age (p = 0.52) and sex (p = 0.679). There was no significant difference regarding pain relief after reduction between the 2 groups (p > 0.05). Mean reduction time was 72.27 ± 15.08 seconds in the traction group and 62.34 ± 24.35 seconds in the rotation group (p According to the results of the present study, Kocher and traction countertraction methods were similar regarding pain relief after reduction and total duration of hospitalization, but reduction time was shorter in Kocher method and treatment failure rate was reported to be higher in this method.

Dislocation of shoulder joint is the most common joint dislocation in the body.This dislocation is the most common one in the 2 period of life. In men between 20-30 years of age due to trauma and sports activities and in women between 60-80 years, usually due to increases in fall. The aim of this study was to determine the prevalence of abnormal radiography in the reduction of anterior shoulder dislocation.
In a one-year cross sectional study, 236 patients with uncomplicated anterior shoulder dislocation who referred to Imam Reza hospital (Mashhad, Iran) were studied. The following data were obtained and recorded: the age and gender of patients, mechanism of injury, radiographs before replacing it up and the interpretation of results, the result of reduction and shoulders immediately following graph reduction, the result of the interpretation of radiographs after reduction, the dislocation and reduction.
The mean age of patients was 31.81 ± 13.22. 174 patients (89%) were male and 26 (11%) were female. Anterior dislocation in 116 patients (49.2%) were right shoulder and in 120 patients (50.8%) were left shoulder. Spontaneous dislocation (61.9%) was the most dislocation mechanism and the external ortation (46.4%) was the most reduction method. Physcial examination before and afer reduction, and the interpretation of radiographs after reduction indicated the correction of anterior shoulder dislocation in all pateints.
This study demonstrated that radiography after anterior shoulder dislocation reduction is not necessary.

Seizure resulted from tramadol can cause bilateral joint dislocation. This study is a rare case report that represents fracture and dislocation of right shoulder due to seizure in a 32years old man that had consumed a 300mg single dose of tramadol. He did not have any history of previous seizure or spontaneous dislocation of the shoulder. The right shoulder radiography and MRI demonstrated dislocation of the head of humerus with fracture of its greater tuberosity. Seizure as a side effects of therapeutic dose of tramadol, can occur during sleep, resulting to serious complications.

Shoulder dislocation is identified as displacement of humerus head from the glenoid cavity of scapula bone, which makes up about 50% of total joint dislocations. Taking into account the importance of the side effects and disabilities caused by this type of dislocation and that it can be prevented, the present study was designed aiming to evaluate the epidemiologic characteristics of the patients with shoulder dislocation. In this retrospective cross-sectional study, all the patients referred to the emergency department (ED) with complaint of shoulder dislocation throughout one year were evaluated. Demographic data and characteristics regarding the type of dislocation, presence of accompanying fractures, mechanism of dislocation, history of dislocation and the method of reduction were extracted from the patients’ profiles and recorded in a checklist designed for this purpose. Data were then statistically analyzed using SPSS version 19. Statistics showed that 120 patients with the mean age of 39.3 ± 21.2 years had been admitted to ED of the studied center in one year (79.2% male). The most common type of dislocation was anterior dislocation (95.8%) and in the right shoulder (52.5%) and the most common cause was falling on open arm (34.2%). Reduction method was non-operative in 93.3% of the cases and surgery in 6.7%. Based on the results of this study, in the studied population, most patients with shoulder dislocation were young men who had an anterior dislocation in their right shoulder because of falling on out stretched hand and treated with close reduction.

Shoulder has the greatest range of motion among our body joints. This makes this joint susceptible to dislocation and subluxation. The most common form of instability of the shoulder is anterior dislocation. Bankart’s essential lesion is the most common cause of recurrent anterior shoulder instability. In this study the results of Bankart operation have been evaluated. Subjects and Thirty cases of recurrent shoulder dislocation underwent open Bankart surgery using anchor suture were selected. These operation were carried out from 1390-1380 in Razi and Emam hospitals in Ahvaz. The cases were evaluated for joint instability، pain according to numerical rating scale، DASH and Rowe Scores، range of motion and movement limitation. Data was analyzed using Fisher exact test and SPSS17 program. The mean age of the patients was 6. 65±33. 7 years. The mean forward elevation، internal rotation، external rotation and abduction were 150، 47، 36 and 156 degrees respectively، which were just a little less than normal lower limits. Mean reduction of external rotation was 5 degree (20-0). According to ROWE score the excellent، good and faire result were 64%، 23% and 13%. DASH score mean was 38. 83 (normal range 66-30). None of them had recurrence or osteoarthritis in radiography. According to the results of this study it seems that open Bankart surgery is an effective method for reducing pain and recurrence of shoulder dislocation.

Anterior glenohumeral instability is associated with anteroinferior rim defect of glenoid. Evaluation of such bony lesions may play a role in determining proper treatment and predicting recurrence of instability. The main purpose of the current study was to investigate the relation between number of dislocations and extent of bony lesion of the glenoid and also determine the sensitivity and specificity of 3-D CT for detection of patients requiring bone-grafting surgery. Thirty patients with recurrent anterior shoulder dislocation contributed to this study. The patients underwent bilateral 3-D CT imaging to determine the glenoid index (GI). Then the correlation between the number of dislocations and GI and also sensitivity and specificity of CT were determined. The bony lesion was present in 28(94%) of patients. There was no meaningful relationship between the number of dislocations and GI (p=.05). Based on the CT 2 patients required open surgery and bone grafting and 28 patients only Bankart procedure. This was proved to have been wrong in 2 cases at surgery. So the sensitivity and specificity of 3-D CT was 50% and 96% respectively. The number of dislocations cannot determine the extent of the bony glenoid defect in recurrent shoulder dislocation lesion. 3-D CT can help in knowing the expansion and location of the lesion but is not a reliable tool for surgical technique.

Simultaneous anterior fracture-dislocation of the shoulder and fracture of the ipsilateral humeral shaft results from severe trauma and is very rare. In this report we present such an injury and its treatment. Case Report: A 48-year old man was brought to hospital after a motor bike accident with anterior dislocation of the shoulder and fracture of the ipsilateral humeral shaft and greater tuberosity.Both injuries were treated by open reduction and internal fixation By timely diagnosis of this rare and disabling injury, full treatment can be given. Thus, performing an accurate examination and obtaining the essential x-rays are mandatory.

Treatment of recurrent shoulder dislocation with open technique has a long successful history in orthopaedic surgery. Arthroscopic repair, however, has a much shorter history especially in Iran. This is a short-term follow-up study of such an operation in Iran. Forty patients (39 males, 1 female) with recurrent anterior shoulder dislocation who had undergone arthroscopic stabilization over a two-year period were evaluated in a retrospective study. The cases had a mean age of 25.3 years, and had 15.5 months (6-30 months) average follow-up. The assessment scores were “The University of California-Los Angeles” (UCLA), “Rowe” and “American Shoulder and Elbow Society Scores” (ASES). Mean Rowe score was 95.5 (77-100); with excellent scores in 32 patients, good in 4, fair in 3 and poor in one. Mean UCLA score was 33.3 (25-35), with good and excellent results in all but 4 cases. ASES was 2-3 in 3 patients, and the rest being painless and without any symptoms. Thirty six patients returned to their previous levels of activity, and achieved good results; the results were fair in 3, and poor in one patient who had recurrent instability. Short-term results of arthroscopic repair of anterior shoulder instability are encouraging.