OMUZ ÇIKIĞINDA GÜVENİLİR ETKİN VE BASİT BİR YÖNTEM: SPASO TEKNİĞİ

Year 2018, Volume: 11 Issue: 1, 1 - 5, 08.07.2019

Cihan Adanaş Sezai Özkan

Abstract

Omuz vücudumuzda meydana gelen eklem
çıkıklarından en sık görülenidir. Omuz çıkıklarında
bir çok redüksiyon yöntemi tanımlanmış ve
hangi yöntemin daha güvenli,
etkin ve kolay olduğu ile
ilgili bir çok çalış ma mevcuttur. Bu çalış mada anestezi
gerektirmeyen etkili ve güvenilir bir redüksiyon
yöntemi olan Spaso tekniği ile omuz
redüksiyonu yapılan hastaların
sonuçlarının literatür eşliğinde sunulması amaçlandı. Bu çalış mada 2011-2017 yılları arasında
hastaneye anterior omuz çıkığı nedeniyle başvuran 43 (39 erkek, 4 kadın)
hasta çalış maya alındı. Hastaların yaşı,
c insiyeti, çıkığın bulunduğu ekstremite
tarafı, çıkığın üzerinden geçen süre, çıkığ ın oluş nedeni ve nörovasküler muayene sonuçları
retrospektif olarak kaydedildi. Hastaların hiç birine Redüksiyon öncesi ve redüksiyon sırasında analjezik, sedasyon ve anestezi uygulanmadı. Hastalara anteior omuz
çıkığı redüksiyonu için Spaso  yöntemi  ile redüksiyon  
uygulandı. Çalış maya
dâhil edilen hastaların 31’inde sağ, 12’sinde
sol omuz çıkığı vardı. Çıkıkların; 19 hasta el üzerine düşme, 11 hasta spor müsabakası esnasında
düşme, 7 hasta minimal travma (elb ise
giyme, yüzme gibi) sonrası ve 6 hasta
doğal afet sırasında (Van depremi) meydana geldiğ i bildirilmiştir. Çıkık oluşumu ile hastaya müdahale sırasına kadar
geçen otalama süre 170 dakika (30 dk-420 dk) id
i. Ortalama redüksiyon süresi 2,8 dakika
(dağılım:1-4) olarak kaydedildi.
Anterior omuz çıkığı redüksiyonu için Spaso
yönteminin anestezi gerektirmeyen
basit, etkili ve güvenilir bir redüksiyon manevrizması olduğu kanaatine varıldı.

Keywords

Omuz çıkığı, Spaso teknik, , Kapalı redüksiyon

EFFECTIVE AND SIMPLE METHOD OF SHOULDER DISLOCATION: SPASO TECHNIQUE

Abstract

The
shoulder jo
int is the most
common dislocation of our body.
Although many reduction methods have been described in shoulder
dislocations, there is no  clear
result  of
which method is easier, safer and more
effective. In this study, we
aimed to present the results of spaso technique in the treatment
of
anterior shoulder
dislocation. 43 (39 male,
4 female) patients with anterior shoulder dislocation were included in our study between
the years of 20011-2017. Age, sex, dislocation side, dislocation
time, dislocation and neurovascular exa mination results were recorded
retrospectively. None of the patients received analgesic, sedation
and anesthesia before and after reduction. patients underwent reduction with Spaso
Miljesic method for reduction of
Anteior shoulder dislocation. Thirty-seven patients had right shoulder
dislocation and 12 patients had left shoulder dislocation. 19 patients
had fall on hand, 11 patients
had fall
during sports competition, 7
patients had minimal trauma (dress wear,
swimming) and 6 patients had
a natural disaster (van
earthquake). The interval between the
occurrence of dislocation and the time of intervention to the patient was 170 min (30 min-420 min). Average reduction time was recorded as 2.8 minutes (range: 1-4). We
conclude that the Spaso method for anterior shoulder dislocation reduction is a simple, effective and reliable reduction maneuver that does not
require anesthesia.

Keywords

Shoulder dislocation, Spaso technique, closed reduction

References

• Beattie TF, Steedman DJ, McGowan A, Robertson CE. A comparison of the Milch and Kocher techniques for acute anterior dislocation of the shoulder. Injury. 1986;17:349-52.
• Chung CH. Closed reduction techniques for acute anterior shoulder dislocation: from Egyptians to Australians. Hong Kong J Emerg Med. 2004;11:178-88.
• Cutts S, Prempeh M, Drew S. Anterior shoulder dislocation. Ann R Coll Surg Engl. 2009; 91:2–7
• Dannenbaum J, Krueger CA, Johnson A A review of reduction techniques for anterior glenohumeral joint dislocations. J Spec Oper Med. 2012;12(2):83-92
• Doyle WL, Ragar T. Use o f the scapula r manipulation method to reduce an anterior shoulder dislocation in the supine position. Ann Emerg Med. 1996;27(1):92-4.
• Eachempati KK, Dua A, Malhotra R, Bhan S, Bera JR. The external rotation method for reduction of acute anterior dislocations and fracture-dislocations of the shoulder. J Bone Joint Surg Am. 2004;86-A:2431-4.
• Garnavos C. Technical note: modifications and improvements of the Milch technique for the reduction of anterior dislocation of the shoulder without premedication. J Trauma. 1992;32:801-3.
• Gleeson AP. Anterior glenohumeral dislocations: what to do and how to do it. J Accid Emerg Med. 1998;15(1):7-12.
• Jamali S. Anterior shoulder dislocation. Aust Fam Physician. 2011;40:133–137.
• Janecki CJ, Shahcheragh GH. The forward elevation maneuver for reduction of anterior dislocations of the shoulder. Clin Orthop Relat Res. 1982;164:177-80.
• Kocher T. Eine neue reductionsmethode für Schulterverrenkung. Berliner Klin Wehnschr. 1870;7(9):101–105.
• Kothari RU, Dronen SC. Prospective evaluation of the scapular manipulation technique in reducing anterior shoulder dislocations. Ann Emerg Med. 1992;21:1349–1352 35. Kuhn JE. Treating the initial anterior shoulder dislocation an evidence based medicine approach. Sports Med Arthrosc. 2006;14:192–198 17.
• Leidelmeyer R. Reduced! A shoulder, subtly and painlessly. Emerg Med. 1977;9:233-4.
• Lippit S, Matsen FA. Mechanisms of glenohumeral joint instability.Clin Orthop. 1993;291:20–28.
• Mahiroğulları M, Akyıldız F, Köksal I, Cakmak S, Kürklü M, KuşkucuM. Chair method: a simple and effective method for reduction of anterior shoulder dislocation. Acta Orthop Traumatol Turc. 2012;46:102-6.
• Manes HR. A new method of shoulder reduction in the elderly. Clin Orthop Relat Res. 1980;147:200-2.
• Marinelli M, Palma L. The external rotation method for reduction ofacute anterior shoulder dislocations. J Orthopaed Traumatol. 2009; 10:17–20
• Matsen FA, Thomas SC, Rockwood CA, Wirth MA. Glenohumeral instability In: Rockwood CA, Matsen FA, editors. The shoulder. 2nd ed., Vol 2. Philadelphia, PA: WB Saunders; 1998: 611-54.
• McNamara RM. Reduction of anterior shoulder dislocation by scapular manipulation. Ann Emerg Med. 1993;22(7):1140-4
• Milch H. The treatment of recent dislocations and fracturedislocations of the shoulder. J Bone Jt Surg. 1949.31:173–1808.
• Milch H. Treatment of dislocation of the shoulder. Surgery.1938;3:732-8.
• Miljesic S, Kelly AM. Reduction of anterior dislocation of the shoulder: the Spaso technique. Emerg Med. 1998;10:173–5.
• Plummer D, Clinton J. The external rotation method for reduction of acute anterior shoulder dislocation. Emerg Med Clin North Am. 1989;7(1):165-75.
• Riebel GD, McCabe JB. Anterior shoulder dislocation: a review of reduction techniques. Am J Emerg Med. 1991;9:180-8.
• Stimson LA.An easy method of reducing dislocations of the shoulder and hip. Med Record. 1900;57:356–357.
• Thakur AJ, Narayan R. Painless reduction of shoulder dislocation by Kocher’s method. J Bone Jt Surg Br. 1990; 72:524.
• Uehara DT, Rudzinski JP. Injuries to the shoulder complex and humerus. In: Tintinalli JE, Kelen DG, Stapczynski JS (eds) Emergency medicine: a comprehensive study guide, 5th edn. Mcgraw-Hill, New York. 2000;1783–1791.
• Ufberg JW, Vilke GM, Chan TC, Harrigan RA. Anterior shoulder dislocations: beyond traction-countertraction. J Emerg Med. 2004;27:301-6.
• Ugras AA, Mahirogullari M, Kural C, Erturk AH, Cakmak S. Reduction of anterior shoulder dislocations by Spaso technique: clinicalresults. J Emerg Med. 2008;34:383-7.
• Visser CPJ, Coene LN, Brand R, Tavy DL. The incidence of nerve injury in anterior dislocation of the shoulder and its influenc e on functional recovery . A prospective clinical and EMG study. J Bone Jt Surg Br. 1999; 81:679–685.
• Yuen MC, Yap PG, Chan YT, Tung WK. An easy method to reduce anterior shoulder dislocation: the Spaso technique. Emerg Med J. 2001;18:370-2.