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简介：AbstractPurpose:The majority of acute anterior shoulder dislocations are sustained during sports and wilderness activities. The management of acute dislocations in the pre-hospital setting is currently without guidelines based on the evidence. The study aims to assess the risk of acute complications in pre-hospital shoulder reduction and identify which pre-hospital reduction technique has the highest success rate in the published literature.Methods:The involved databases were Allied and Complementary Medicine, CENTRAL, CINAHL, Cochrane Database of Systematic Reviews, Embase, Europe PMC, Ovid MEDLINE®, Pedro, Proquest, Trip, and World Health Organization International Clinical Trials Registry platform. Only original research of high methodological quality was included, which was defined by the recently developed assessment tool-assessing the methodological quality of published papers (AMQPP) and investigated the management of acute anterior shoulder dislocations in the pre-hospital setting.Results:Two hundred and ninety-eight articles were identified and screened. A full text review was performed on 40 articles. Four articles published between 2015 and 2018 met the inclusion criteria. A total of 181 patients were included with the study duration ranging from 6 to 60 months. All studies reported zero immediate complication following pre-hospital reduction and there were no documented subsequent adverse events regardless of the technique used. Prompt resolution of neurological symptoms was observed following the early and successful pre-hospital reduction. First attempt success rate, when performed by skilled practitioners, ranged from 72.3% to 94.9%.Conclusion:Pre-hospital shoulder reduction appears to be a safe and feasible option when carried out with the appropriate expertise. A novel reduction technique adapted from the mountain medicine diploma course at the University of Paris North was found to have the highest first attempt reduction success rate of 94.9%. Other techniques described in the literature included Hippocratic, Stimson's, Counter-traction and external rotation with the success rates ranging from 54% to 71.7%.

简介：Objective:Toinvestigatetheindication,perioperativeannouncements,selectionofprosthesisandclinicalresultsofshoulderhemiarthroplastyforthetreatmentofcomplexproximalhumeralfractures.Methods:Atotalof55patientswhosufferedfromcom-plexproximalhumeralfracturesweretreatedbyshoulderhemiarthroplasty.Themeanagewas55.6yearsandmeanfollow-upperiodwas25.1months.Thescoringsystemmodi-ficationforhemiarthroplasty(SSMH)hadbeenadoptedforevaluationatthelatestfollow-up.Results:Thepainwasobviouslyrelievedinallpatients.Fiftypatientswerepainlessand5patientshadslightpain.Themeanrangeofmotionwas100°(90°-110°)inabduction,95°(80°-100°)inforwardflexion,35°(30°-40°)inextemalrotationandinternalrotationwasconfinedatL2level(L1-L3).ThemeanSSMHscorewas27.9(24-29).Fiftypatients(90.1%)weresatisfiedwiththeclinicaloutcome.Conclusions:Shoulderhemiarthroplastyisaneffectivemethodtotreatcomplexproximalhumeralfractures.Theproperselectionofpatientsandprosthesis,goodoperationskillandenoughfunctionalexercisearethekeypointsofsuccessfultreatment.

简介：以推拿手法作用于患侧肩关节周围，结合针刺风池、肩中俞、肩井、天宗、曲池和合谷，治疗肩周炎患者100例，治疗3个疗程后，治愈82例，好转18例，全部有效。

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简介：Acupuncture,TuinaandcombinationofacupunctureandTuinawereusedtotreat250casesofshoulderperiarthritiswhowererandomlydividedintothreegroups.Bingfeng(SI12)andAshipointswereselectedandcuppingtherapywasalsogivenfollowingacupunctureinacupuncturegroup;pressing,kneadingandpluckingmanipulationswereperformedinTuinagroup,acupunctureplusTuinawereemployedingroupofacupunctureplusTuina.ThetherapeuticresultsshowedacupunctureplusTuinawasbetterthansimpleTuina,andstatisticalanalysesdemonstratedP＜0.05.

简介：Jiansanzhen,Tianzong(SI11),Jugu(LI16),Jianzhen(SI9),Binao(LI14)andQuchi(LI11)weregivenwarming-needlemoxibustiontotreatshoulderperiarthritisin78cases,andtheresultshowedtotaleffectiveratewas97.4%.

简介：目的：观察电针对中风偏瘫肩手综合征的治疗效果。方法160例患者随机分为两组，其中对照组80例，以传统毫针针刺法治疗，治疗组80例运用电针针刺法治疗两个疗程后判定疗效。结果：两个疗程后显示电针组手背水肿、屈指时手痛的疗效及总显效率均优于毫针组（P〈0．05）。结论：电针对消除手背水肿，防止手部肌肉萎缩，促进中风的康复有重要意义。

简介：双边的肩膀脱臼arerare并且几乎总是发生在以后的方向。同时的双边的前面的肩膀脱臼甚至更稀罕，仅仅一些案例在文学被说。当同步、同时的力量被需要导致它，双边的肩膀脱臼的最有趣的部分关于它的损害机制。在癫痫或电刑的情况下，机制是不同的，肌肉的选择的组的有力的收缩导致脱臼。这篇文章报导在一个癫痫的病人发生在一个道路方面事故以后并且在骚动的一个事件以后的双边的同时的前面的肩膀关节脱臼的二个案例。脱臼早被诊断并且与合适的postreduction康复立即减少了。在他们的后续期间，bothpatients有令人满意的功能的结果。这篇文章在道路方面事故牺牲品和癫痫的病人在肩膀检查的重要性上强调。所有矫形surgeonsand紧急情况医生应该知道如此的不平常的可能性有早诊断和治疗。早减小和适当康复能提供令人满意的功能的结果。这篇文章简短也讨论损害机制，诊断并且在文学报导了的双边的肩膀脱臼的治疗。

简介：目的：观察经皮穴位电刺激对粘连前期肩关节周围炎的治疗作用。方法：采用大样本、多中心、随机化等循证医学研究方法，对163例粘连前期肩关节周围炎患者分别进行经皮穴位电刺激治疗和电针治疗，观察经皮穴位电刺激对粘连前期肩周炎的治疗作用及与电针治疗的效应比较。结果与结论：经皮穴位电刺激对粘连前期肩周炎的总有效率达到96．59％，与电针比较无明显差异；该疗法不仅具有明显的止痛效应，对肩关节活动障碍也有明显的改善作用。经皮穴位电刺激为治疗肩周炎有效、简便的疗法。

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简介：AbstractPurpose:Posterior fracture-dislocation of shoulder is an infrequent traumatic event; however, most orthopaedic surgeons may face the challenge of treating it. The aim of this study is to review and summarise systematically the current principles of the management of this complex injury, and create a treatment algorithm.Methods:Both PubMed and Scopus Databases were systematically searched for the terms "posterior shoulder fracture-dislocation" or "posterior glenohumeral fracture-dislocation" or "posterior glenoid fracture-dislocation" for articles written in English and published in the last decade.Results:A total of 900 articles were identified, of which 13 were retained for analysis. A total of 153 patients (161 shoulders) were identified. These patients were treated either with open reduction and internal fixation, modified McLaughlin procedure, allograft/autograft humeral head reconstruction or shoulder arthroplasty. The mean age was 40.15 years. The mean postoperative Constant score in cases treated by open reduction and internal fixation was 86.45, whereas by bone graft was 84.18. Further, the mean postoperative Constant score was between 79.6 and 67.1 in those that were managed by modified McLaughlin and arthroplasty procedure, respectively.Conclusion:The management of posterior shoulder fracture-dislocation may be challenging, and the best surgical option depends on many variables such as the chronicity of the injury, the presence of a fracture at the level of the surgical neck or tuberosities and the extend of the Hill-Sachs lesion if any. A treatment algorithm is proposed, based on the current literature in an effort to create a consensus for these injuries. For the acute shoulder fracture-dislocations, an open reduction should be performed. For the chronic fracture/dislocations in the elderly low-demand patients, conservative treatment should be performed. For the rest of the patients, depending on the severity of the Hill-Sachs lesion different surgical options are available such as the McLaughlin technique, the use of an allograft, osteotomy or arthroplasty.

简介：AbstractArthroscopic superior capsular reconstruction is an innovative technique for the irreparable rotator cuff tears, but spontaneous pneumothorax after surgery is very rare. The present case was a 66-year-old female with irreparable rotator cuff tears of the right shoulder, treated with the arthroscopic shoulder superior capsular reconstruction. The general anesthesia and operation went smoothly, but the patient experienced stuffiness in the chest and shortness of breath after recovery from anesthesia. Thoracic CT scans showed spontaneous pneumothorax in the right side, which was successfully treated by the conservative treatments (oxygen therapy) according to multidisciplinary team. Prompt and accurate early-stage diagnosis is necessary in controlling postoperative complications and standardized treatment is the key to relieve the suffering. Spontaneous pneumothorax after arthroscopic shoulder surgery has been rarely reported in previous literatures.

简介：在海洋的申请，海洋的等级钢通常被使用为拖并且上层建筑。然而，铝也由于它的小质量成为了一种好选择，当铝生锈与钢相比是最小的时。在磨擦上在这糊研究促使铝合金焊接被介绍。现在的调查处理不同磨擦的效果促使在机械强度和铝合金焊接的微观结构性质上焊接工具几何学。有肩膀和工具探查侧面的不同类型的三不同工具几何学根据设计矩阵在调查被使用。焊接上的每个工具肩膀和探查几何学的效果被评估。磨擦搅动焊接工具几何学，这也被观察在焊接加强，microhardness，和焊接强度上有重要效果。

简介：目的：探讨针灸治疗中风后偏瘫肩痛的临床疗效。方法：将90例中风后偏瘫肩痛患者按1：1：1随机分为3组。分别采用针灸、针灸加中药、中药进行治疗。结果：3组间疗效、全血黏度经统计学处理，针灸组、针灸加中药组与中药组相比具有显著性差异（P〈0．01）；而针灸组与针灸加中药组之间无显著性差异（P〉0．05）。结论：针灸治疗对中风后偏瘫肩痛具有良好疗效，对异常全血黏度有近期调节降低作用。

简介：AbstractPurpose:Recurrent dislocation of shoulder (RDS) is a common injury in high demand professionals, like athletes and military personnel. The treatment for the patients with Bankart lesion is the arthroscopic repair. This present study compares the outcomes of two different techniques of arthroscopic Bankart repair i.e. a standard two anterior portals technique and a single anterior portal technique in patients with RDS.Methods:Patients with traumatic RDS met the inclusion criteria were managed with Bankart repair using either two anterior portals (Group A) or a single anterior portal (Group B) technique. Patients were evaluated before the intervention and at the mean follow-up of approximately two years using Rowe score, Oxford shoulder score and Tegner activity scale.Results:The mean age of the patients in Groups A (n = 34) and B (n = 37) was 29.64 years and 29.05 years respectively (p = 0.66). The dominant shoulder was involved in 27 patients in Group A and 22 patients in Group B (p = 0.069). The operative time in Group A and B was 68.52 min and 46.35 min, respectively (p < 0.001). The complications at follow-up, the mean Rowe score and Oxford score improved significantly in both groups compared with the pre-operative values. However, the final outcome scores were not significantly different between the both groups. The median Tegner's score preoperatively and at follow-up was 7 and 6, respectively in Groups A and B.Conclusions:Single anterior portal technique is an effective treatment modality, yielding a similar outcome as two anterior portals technique in the management of RDS.

简介：BACKGROUND:Clinicaldiagnosisofvariousneurologicaldisordersinvolvingthesensorynervesdependsprimarilyonsubjectivedescription,whichcannotbequantitativelyevaluated,andisalsolessreproducibleandspecific.QuantitativesensorytestingmethodscanovercometheseshortcomingsandiscurrentlyusedtoidentifythefunctionoftheC-andA-fibers.OBJECTIVE:Toapplythequantitativesensorytestingmethodforanalyzingchangesintemperaturesensation,cryalgesia,thermalgesia,andvibrationsenseontheskinsurfaceofhemiplegicpatientswithpost-strokeshoulder-handsyndrome,andtoanalyzetherelationshipbetweenthesechangesandshoulder-handsyndrome.DESIGN,TIMEANDSETTING:Anon-randomized,concurrent,controlstudywasperformedattheClinicandInpatientDepartmentoftheThirdXiangyaHospital,CentralSouthUniversity,betweenJune2000andApril2001.PARTICIPANTS:Thirtypost-stroke,hemiplegicpatientsweredividedintoshoulder-handsyndromeandcontrolgroups,accordingtowhetherpatientsexhibitedshoulder-handsyndrome,with15patientsineachgroup.METHODS:ATSA2001quantitativesensorytestingdevice(Medoc,Israel)wasusedforquantitativesensorytesting.Allsensorytestingemployedlimits,testingtemperaturesenseonthepalmthenareminenceandvibrationsenseonthethumbmetacarpal.Coldthresholdwas≤28℃,warmththresholdwas≥36℃,cold-evokedpainthresholdwas≤5℃,heat-evokedpainthresholdwas≥51℃,vibrationthresholdwas≥5μm/s;ifapatientmetoneoftheseitems,he/shewasconsideredtobehypoanesthesia.MAINOUTCOMEMEASURES:Cold,warm,cold-evokedpain,heat-evokedpainandvibrationthresholdchangesonskinfromtheparalyzedupperextremitywasmeasuredintheshoulder-handsyndromeandcontrolgroups.RESULTS:Incidenceofsensorydisabilityintheshoulder-handsyndromegroupincreasedmoresignificantlythaninthecontrolgroup(P<0.05),withtheprimarymanifestationsbeingdecreasedcoldthreshold(P<0.