Clinical Study Of External Rotation Abduction Fixation With Treatment Of Shoulder Dislocation

Objective: Internal rotation fixation of the affected limb after manual traction reduction is a traditional treatment for anterior dislocation of the shoulder,but the rate of re-dislocation of the shoulder joint is very high.How to reduce the rate of shoulder redislocation is the focus of the treatment of shoulder dislocation.In recent years,some scholars have found that the injured shoulder joint tissue is more conducive to healing in external rotation abduction position,so the idea of using external rotation abduction stent to treat traumatic anterior dislocation of shoulder joint is put forward,and some foreign researchers have also carried out related treatment research.However,there are few similar research reports in China.By comparing the shoulder redislocation rate,brace comfort and shoulder function score of different fixation groups,this study explored the effects of fixed position,age,sex and other factors on the shoulder redislocation rate.Methods: This is a prospective randomized controlled trial.Forty-eight patients with anterior shoulder dislocation treated in the Department of Orthopaedics,affiliated Hospital of Northwest Minzu University from January 2018 to March 2019 were randomly divided into internal rotation fixation group(24 cases)and external rotation abduction fixation group(24 cases).The average age of the patients was 37.3±1.1 years old,including 31 male patients and 17 female patients.After successful reduction,the shoulder joint was fixed in different fixed positions for 3 weeks,and the fixed brace was removed 3 weeks later.2 months later,the shoulder joint MRI was performed to determine the repair degree of tissue injury around the shoulder joint.After removing the fixation device,the telephone follow-up was continued for 12 months.Record the number of patients with shoulder redislocation during 12 months,improve the relevant scores,and finally use statistical software to analyze the experimental data.Results: Among the 48 patients in the group,2 lost follow-up in the course of treatment.During the follow-up of 12 months,there were 9 cases of shoulder dislocation in IR group and 2 cases in ER group.There was significant difference in the rate of shoulder redislocation in different fixation groups(P<0.05).It was considered that the rate of shoulder redislocation in ER group was significantly lowerthan that in IR group.In IR group,there were 7 cases of male subluxation and 2 cases of female subluxation.In ER group,there were 2 cases of male subluxation and 0 case of female subluxation.The difference of shoulder joint redislocation rate in different genders were compared between the two groups(P>0.05).It was considered that there was no significant difference in the incidence of shoulder redislocation between different genders.In IR group,there were 5 cases of redislocation in 18-30 years old,and 4 cases in31-65 years old patients.In ER group,there was 1 case in 18-30 years old patients and1 case in 31-65 years old patients.The difference of shoulder joint redislocation rate in different age groups was compared between the two groups(P>0.05).It was considered that there was no significant difference in shoulder joint redislocation rate in different age groups.The visual analogue score(VAS)was used to compare the wearing comfort of different fixed braces(P<0.05).The VAS score of internal rotation fixation group was significantly lower than that of external rotation abduction fixation group,and the brace of internal rotation fixation group was more comfortable.The shoulder joint function score table was used to compare the shoulder joint function after fixation with different braces(P<0.05).The shoulder function score of the external rotation abduction position fixation group was significantly higher than that of the internal rotation position fixation group.the recovery of shoulder function was better in the external rotation abduction position fixation group.Conclusion: The total shoulder redislocation rate of the external rotation abduction fixation group was significantly lower than that of the internal rotation fixation group,but there was no significant difference in the shoulder redislocation rate of different genders and ages between the external rotation abduction fixation group and the internal rotation fixation group.Although the wearing comfort of the fixed brace in the external rotation abduction position is poor,the functional recovery of the shoulder joint in the external rotation abduction fixation group is better,which can accelerate the early and complete repair of the injured tissue around the shoulder joint.The fixed method of external rotation abduction fixation is a feasible and effective method for the treatment of anterior dislocation of shoulder joint.