Yıl: 2011 Cilt: 22 Sayı: 1 Sayfa Aralığı: 28 - 32 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder

Öz:
Amaç: Bu çalışmada akut öne omuz çıkığı redüksiyonunda skapular manipülasyon tekniği ile Kocher yöntemi etkinlik, güvenilirlik ve hastalar tarafından hissedilen ağrı açısından karşılaştırıldı. Hastalar ve yöntemler: Temmuz 2009 ile Ocak 2010 tarihleri arasında akut travmatik öne omuz çıkıklı toplam 64 hasta değerlendirildi. Değerlendirmeye alınan 64 hastadan üçü kardiyopulmoner sorunları nedeniyle çalışma dışı bırakıldı. Kalan 61 hasta (41 erkek, 20 kadın; ort. yaş 42±18.5 yıl; dağılım 17-87 yıl) bu ileriye dönük ve randomize çalışmaya dahil edildi ve iki gruba ayrıldı. Otuz bir hasta (grup 1) skapular manipülasyon, 30 hasta ise Kocher yöntemi (grup 2) ile tedavi edildi. Redüksiyondan önce Ramsay sedasyon skalasına göre 1 ya da 2. derecede sedasyon sağlanacak şekilde bir girişimsel sedasyon/analjezi işlemi uygulandı. Redüksiyon sırasında hastalar tarafından hissedilen ağrıyı değerlendirmek için görsel analog skala kullanıldı. Bulgular: Redüksiyon işlemi skapular manipülasyon uygulanan hastaların %96.7’sinde, Kocher yöntemi uygulanan hastaların ise %93.3’ünde başarılı oldu (p>0.05). Grup 1’de hissedilen ağrı derecesi grup 2’ye kıyasla daha düşüktü (p<0.01). Sonuç: Hem skapular manipülasyon hem de Kocher tekniği girişimsel sedasyon ve analjezi işlemi rutin olarak uygulandığında başarılı ve güvenilir yöntemlerdir. Öne omuz çıkığının redüksiyonunda Kocher tekniği ile karşılaştırıldığında skapular manipülasyon daha az ağrılı bir yöntemdir.
Anahtar Kelime:

Konular: Ortopedi

Akut öne omuz çıkığında skapular manipülasyon tekniği ile Kocher tekniğinin karşılaştırılması

Öz:
Objectives: The aim of the present study was to compare the scapular manipulation technique and the Kocher&#8217;s method in terms of efficacy, safety, and the intensity of pain felt by the patient in the reduction of acute anterior shoulder dislocation. Patients and methods: Between July 2009 and January 2010, a total of 64 patients with acute traumatic anterior dislocation of the shoulder were evaluated. Of the 64 patients assessed, three patients were excluded because of cardiopulmonary problems. The remaining 61 patients (41 males, 20 females; mean age 42±18.5 years; range 17 to 87 years) were enrolled in this prospective randomized study and devided into two groups. Thirty-one patients were treated with scapular manipulation (group 1) and 30 patients were treated by the Kocher&#8217;s method (group 2). A procedural sedation/analgesia was applied before the reduction to meet the target sedation score of 1 or 2 according to the Ramsay sedation scale. A visual analog scale was used to determine the intensity of the pain felt by the patients during reduction. Results: Reduction was successfully achieved with the scapular manipulation method in 96.7% of the patients, and with the Kocher&#8217;s method in 93.3% (p>0.05). The degree of pain experienced by group 1 was lower than group 2 (p<0.01). Conclusion: Both scapular manipulation and Kocher&#8217;s techniques are successful and reliable methods when procedural sedation/analgesia is used routinely. Scapular manipulation is a less painful method of reduction of an anterior shoulder dislocation in comparison with the Kocher&#8217;s technique.
Anahtar Kelime:

Konular: Ortopedi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Goss TP. Anterior glenohumeral instability. Orthopedics 1988;11:87-95.
  • 2. Gleeson AP. Anterior glenohumeral dislocations: what to do and how to do it. J Accid Emerg Med 1998;15:7-12.
  • 3. Sayegh FE, Kenanidis EI, Papavasiliou KA, Potoupnis ME, Kirkos JM, Kapetanos GA. Reduction of acute anterior dislocations: a prospective randomized study comparing a new technique with the Hippocratic and Kocher methods. J Bone Joint Surg [Am] 2009;91:2775-82.
  • 4. Baykal B, Sener S, Turkan H. Scapular manipulation technique for reduction of traumatic anterior shoulder dislocations: experiences of an academic emergency department. Emerg Med J 2005;22:336-8.
  • 5. Pimpalnerkar A, Datta A, Longhino D, Mohtadi N. An unusual complication of Kocher’s manoeuvre. BMJ 2004;329:1472-3.
  • 6. Brennan F, Carr DB, Cousins M. Pain management: a fundamental human right. Anesth Analg 2007;105:205-21.
  • 7. Anwari JS. Pain and ethics. The Internet Journal of Health 2008;7:1-7.
  • 8. Johnson EW. Visual analog scale (VAS). Am J Phys Med Rehabil 2001;80:717.
  • 9. Ramsay MA, Savege TM, Simpson BR, Goodwin R. Controlled sedation with alphaxalone-alphadolone. Br Med J 1974;2:656-9.
  • 10. Anderson D, Zvirbulis R, Ciullo J. Scapular manipulation for reduction of anterior shoulder dislocations. Clin Orthop Relat Res 1982;164:181-3.
  • 11. Watson-Jones R. Fractures and joint injuries. Vol 2, 6th ed. Edinburgh: Churchill Livingstone; 1982.
  • 12. Kothari RU, Dronen SC. Prospective evaluation of the scapular manipulation technique in reducing anterior shoulder dislocations. Ann Emerg Med 1992;21:1349-52.
  • 13. McNamara RM. Reduction of anterior shoulder dislocations by scapular manipulation. Ann Emerg Med 1993;22:1140-4.
  • 14. Hussein MK. Kocher’s method is 3,000 years old. J Bone Joint Surg [Br] 1968;50:669-71.
  • 15. Uglow MG. Kocher’s painless reduction of anterior dislocation of the shoulder: a prospective randomised trial. Injury 1998;29:135-7.
  • 16. Leonard M, Kiely P. Reduction of anterior shoulder dislocations: a basic treatment guideline based on clinical practice. Eur J Orthop Surg Traumatol 2007;17:561-5.
  • 17. Onyeka W. Anterior shoulder dislocation: an unusual complication. Emerg Med J 2002;19:367-8.
  • 18. Gleeson AP, Graham CA, Jones I, Beggs I, Nutton RW. Comparison of intra-articular lignocaine and a suprascapular nerve block for acute anterior shoulder dislocation. Injury 1997;28:141-2.
  • 19. Underhill TJ, Wan A, Morrice M. Interscalene brachial plexus blocks in the management of shoulder dislocations. Arch Emerg Med 1989;6:199-204.
  • 20. Pradhan RL, Lakhey S, Pandey BK, Rijal KP. Reduction of acute anterior shoulder dislocations: comparing intraarticular lignocaine with intravenous anesthesia. JNMA J Nepal Med Assoc 2006;45:223-7.
  • 21. Ceccarelli E, Bondi R, Campi S. Evidence in orthopaedics: comparision of intra-articular lidocaine vs. intravenous analgesia and sedation for reduction of acute shoulder dislocation. J Orthopaed Traumatol 2004;5:194-6.
  • 22. Fitch RW, Kuhn JE. Intraarticular lidocaine versus intravenous procedural sedation with narcotics and benzodiazepines for reduction of the dislocated shoulder: a systematic review. Acad Emerg Med 2008;15:703-8.
APA ŞAHİN N, Öztürk A, özkan y, ATICI T, ÖZKAYA G (2011). A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder. , 28 - 32.
Chicago ŞAHİN Namık,Öztürk Alpaslan,özkan yüksel,ATICI Teoman,ÖZKAYA GÜVEN A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder. (2011): 28 - 32.
MLA ŞAHİN Namık,Öztürk Alpaslan,özkan yüksel,ATICI Teoman,ÖZKAYA GÜVEN A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder. , 2011, ss.28 - 32.
AMA ŞAHİN N,Öztürk A,özkan y,ATICI T,ÖZKAYA G A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder. . 2011; 28 - 32.
Vancouver ŞAHİN N,Öztürk A,özkan y,ATICI T,ÖZKAYA G A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder. . 2011; 28 - 32.
IEEE ŞAHİN N,Öztürk A,özkan y,ATICI T,ÖZKAYA G "A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder." , ss.28 - 32, 2011.
ISNAD ŞAHİN, Namık vd. "A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder". (2011), 28-32.
APA ŞAHİN N, Öztürk A, özkan y, ATICI T, ÖZKAYA G (2011). A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), 22(1), 28 - 32.
Chicago ŞAHİN Namık,Öztürk Alpaslan,özkan yüksel,ATICI Teoman,ÖZKAYA GÜVEN A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) 22, no.1 (2011): 28 - 32.
MLA ŞAHİN Namık,Öztürk Alpaslan,özkan yüksel,ATICI Teoman,ÖZKAYA GÜVEN A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), vol.22, no.1, 2011, ss.28 - 32.
AMA ŞAHİN N,Öztürk A,özkan y,ATICI T,ÖZKAYA G A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2011; 22(1): 28 - 32.
Vancouver ŞAHİN N,Öztürk A,özkan y,ATICI T,ÖZKAYA G A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2011; 22(1): 28 - 32.
IEEE ŞAHİN N,Öztürk A,özkan y,ATICI T,ÖZKAYA G "A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder." Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), 22, ss.28 - 32, 2011.
ISNAD ŞAHİN, Namık vd. "A comparison of the scapular manipulation and Kocher’s technique for acute anterior dislocation of the shoulder". Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) 22/1 (2011), 28-32.