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Reducing shoulder dislocation without anaesthesia or assistant:Validation of a new reduction manoeuvre

Chinese Journal of Traumatology 2019年第5期22卷 274-277页

作者： Rashid Anjum Subodh Pathak Atul Rai Sharma Jatin Aggarwal Aryan Sharma Vineet Pruthi Anil Kumar Chaudhary MM Institute of Medical Sciences&Research Ambala13320乙India

Purpose:Shoulder dislocation comprises 60%of all major joint dislocations worldwide and a number of reduction techniques are described in the literature w让h varying degrees of success.The description of a large number of techniques speaks for itself that no method is effective all the times and one should be acquainted with more than one technique.An ideal method of reduction should be simple,easily reproducible,relatively painless that can be performed unassisted without sedation or anaesthesia w让h minimal or no further complications.We report our results of using a novel method of anterior shoulder reduction described recently in the literature that claims to fulfil most of the characteristics of an ideal method if not all.Methods:This prospective study was conducted in a tertiary care centre.All the cases of primary anterior shoulder dislocation presenting within three days of injury without any associated fracture or spine trauma with or without greater tuberosity fracture were included.The reduction was done using a novel method by orthopaedic residents in all cases.The need for a second reduction attempt or anaesthesia was considered a treatment failure.Time taken for reduction,pain felt during reduction and complications if any were noted.Results:There were 47(77.04%)males and 14(22.95%)females with a mean age of(37.04±12.63)years.The new technique was effective in locating a shoulder dislocation on the first attempt in 58 of the 61 dislocated shoulders(95.08%).The remaining three shoulders were reduced on second attempt by the same technique.Sedative,pre-medication or anaesthesia was not used in any case.The average time taken for the shoulder reductio n was(130.5±25.8)sec onds and con fide nee interval(95%)124-137 s.Iatrogenic complications were not seen in any of the patients.Conclusion:This relatively painless technique of shoulder reduction is easy to acquire and practice in emergency department.The advantages of this manoeuvre and its associated safety may justly lead surgeons to select it as their p

关键词： Shoulder dislocation External rotation manoeuvre Prakash's manoeuvre

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Accordion manoeuvre with Ilizarov Frame over Nail <i>in Situ</i>in a Case of Infected Non-Union of Femur: Discussion on Strategies: A Case Report

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Open Journal of Orthopedics 2014年第7期4卷 183-188页

作者： Ranjit Kr. Baruah Department of Orthopaedics Assam Medical College Dibrugarh India

Quiescent Type of H. Rosen & Stage 2 of C.L. Romano et al. for Infected Non Union of Femur after K-nailing (Küntscher nailing) require no debridement & removal of nail and therefore can be treated by a single stage procedure. There are a few reports of treating aseptic non-union of femur by compression alone or compression distraction over nail by Ilizarov Technique. However, no case of Infected Non-Union femur being treated by Accordion manoeuvre with Ilizarov over nail in situ (i.e. without exchange nailing) has been reported so far. Here, we are reporting a case of Infected Non-Union following K-nailing for a fracture shaft of femur in a 15-year-old female, who was treated by this technique as a single stage procedure. An Ilizarov frame was mounted on the femur with nail in situ followed by Accordion manoeuvre. The fracture was healed in 5.6 months with two cycles of Accordion manoeuvre followed by rhythmic compression. There was no recurrence of infection.

关键词： Infected Non-Union Femur Accordion manoeuvre by Ilizarov over Nail in Situ

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Pitfalls in spirometry: Clinical relevance

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World Journal of Respirology 2014年第3期4卷 19-25页

作者： Andrea Antonelli Giulia Michela Pellegrino Giuseppe Francesco Sferrazza Papa Riccardo Pellegrino Allergologia e Fisiopatologia Respiratoria ASO S.Croce e Carle 12100 Cuneo Italy U.O.Pneumologia Ospedale San Paolo Università degli Studi di Milano 20122 Milan Italy

Spirometry is one of the functional tests most used in respiratory medicine to assess lung function in health and disease conditions.Its success is grounded on solid principles of lung mechanics that state that maximal flow on expiration is limited by the physical properties of airways and lung parenchyma.In contrast,on inspiration,flow depends on the force generated by the inspiratory muscles.Reduced expiratory forced flow and volumes usually reflect a deviation from health conditions.Yet due to a complex interplay of different obstructive and restrictive lung diseases within the multiple structural dimensions of the respiratory system,flows and volumes do not always perfectly reflect the impact of the disease on lung function.The present review is intended to shed light on a series of artefacts and biological phenomena that may confound the clinical interpretation of the main spirometric measurements.Among them is thoracic gas compression volume,the volume and time history of the inspiratory manoeuvre that precedes the forced expiration,the effects of heterogeneous distribution of the disease across the respiratory system,and the changes in lung elastic recoil.

关键词： Spirometry Thoracic gas compression volume Volume history effects of the deep breath Time history effects of the preceding inspiratory manoeuvre Ventilation heterogeneities Lung elastic recoil Clinical interpretation

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