RESUMEN
The Spaso technique consists of forward flexion, external rotation, and gentle traction for the reduction of anterior shoulder dislocations with the patient in the supine position. The aim of this prospective study was to assess clinical efficacy of the Spaso technique and to evaluate its complications. We prospectively evaluated 52 shoulder dislocations using the Spaso technique. All reductions were performed by residents in training. Rescue methods if initial reduction was unsuccessful were at the discretion of the treating physician. Fifty-two patients were enrolled and 39 (75%) dislocations were successfully reduced without anesthesia or assistance. The mean reduction time was 3.2 min, and 87% of successful reductions occurred in less than 5 min. If we exclude the first 20 cases as a learning period, the success rate increases up to 87.5%. There were no complications associated with using the Spaso technique in this series. Patients with concomitant greater tuberosity fractures and late presentation had a lower success rate, although this was not statistically significant. The Spaso method is effective in reducing anterior shoulder dislocations without anesthesia or assistance and may decrease reduction time and length of stay in the Emergency Department.
Asunto(s)
Manipulación Ortopédica/métodos , Luxación del Hombro/terapia , Adolescente , Adulto , Anciano , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Humanos , Internado y Residencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Luxación del Hombro/clasificación , Resultado del TratamientoRESUMEN
Osseous hydatid disease is caused by the parasitic tapeworm Echinococcus. The species most responsible for hydatid disease is Echinococcus granulosus, endemic especially in sheep-rearing districts like Mediterranean countries and Australia. In Turkey, the exact incidence of human hydatid disease is not known, but < or =34% of asymptomatic farmers have positive serology. Bone hydatidosis is rare, making up 0.5% to 4% of all cases. Patients usually present with pain, swelling, or pathological fracture. There are no specific radiographic signs in affected bone. In the later stages, lytic lesions with a trabeculated pattern, with or without sclerosis, may be seen. Computed tomography (CT) is still the best method for diagnosis and posttherapy follow-up of osseous hydatidosis. On CT, skeletal cystic hydatidosis appears as one or several closely related, well-defined, osteolytic lesions. There may be bone expansion, cortical thinning, cortical destruction, sclerosis, honeycomb appearance, and extension into adjacent soft tissues.