SPORTS MEDICINE
Reduction of acute anterior dislocations: A prospective randomized study comparing a new technique with the Hippocratic and Kocher methods
This report has been verified
by one or more authors of the
original publication.
Este estudo foi identificado como tendo um impacto potencialmente elevado.
A métrica de Alto Impacto da OE, baseada em IA, estima a influência que um artigo poderá ter, integrando sinais da revista em que foi publicado e do conteúdo científico do próprio artigo.
Desenvolvido com recurso ao mais avançado processamento de linguagem natural, o modelo High Impact da OE prevê com maior precisão o desempenho futuro de um estudo em termos de citações do que o fator de impacto da revista por si só.
Isto permite o reconhecimento precoce de investigação clinicamente significativa e ajuda os leitores a concentrarem-se nos artigos com maior probabilidade de moldar a prática futura.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(2):188 J Bone Joint Surg Am. 2009 Dec;91(12):2775-82.154 patients with acute anterior dislocation of the glenohumeral joint were randomized to receive either FARES (fast, reliable, safe) reduction, Hippocratic method reduction, or Kocher method reduction. This trial evaluated the efficacy of the FARES reduction method and compared it to the two common methods currently in use. The results from this trial indicated that the FARES method of glenohumeral joint reduction was significantly more efficacious, faster, and associated with less pain when compared to the Kocher and Hippocratic methods.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sim = 1
Incerto = 0,5
Não relevante = 0
Não = 0
A Avaliação dos Critérios de Relato avalia a transparência com que os autores relatam as caraterísticas metodológicas e do ensaio na publicação. A avaliação está dividida em cinco categorias que são apresentadas de seguida.
3/4
Randomization
3/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
3/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
O Índice de Fragilidade é uma ferramenta que auxilia na interpretação de achados significativos, fornecendo uma medida de força para um resultado. O Índice de Fragilidade representa o número de eventos consecutivos que precisam de ser adicionados a um resultado dicotómico para que o resultado deixe de ser significativo. Um número pequeno representa um resultado mais fraco e um número grande representa um resultado mais forte.
Porque é que este estudo era necessário agora?
Anterior dislocations of the glenohumeral joint are common. Although several methods of reduction of anterior dislocations of the shoulder exist, few studies have compared efficacy, safety, and reliability of the different techniques. In this study, a new method of reduction of acute anterior shoulder dislocations was compared to the Hippocratic and Kocher methods.
Qual era a principal questão de investigação?
In patients with acute anterior dislocation of the glenohumeral joint, are FARES, Hippocratic, and Kocher reduction methods comparable in terms of efficacy and pain?
Quais foram os resultados importantes?
- Reduction was achieved for 88.7% (47) patients in the FARES group; 72.5% (37) patients in the Hippocratic method and for 68% (34) in Kocher group. Efficacy significantly favored the FARES technique (p=0.033)
- Reduction was significantly faster with the FARES method, as compared to the other two methods (FARES, time in minutes, 2.36 ± 1.24; Hippocratic, 5.55 ± 1.58; Kocher, 4.32 ± 2.12) (p<0.001)
- Pain was significantly milder when reduction was performed using the FARES technique (VAS scores: FARES, scale 0-9, 1.57 ± 1.43; Hippocratic, 4.88 ± 2.17; Kocher, 5.44 ± 1.92) (p<0.001)
De que é que me devo lembrar mais?
The FARES method was found to be significantly more effective, faster, and less painful when compared to the Hippocratic and Kocher methods of reduction for anterior glenohumeral dislocation. Moreover, the technique was performed by only one physician and was applicable to anterior shoulder and simple fracture-dislocations.
Como é que isto afectará o tratamento dos meus doentes?
FARES method appears to be the optimal technique to reduce anterior dislocations of the glenohumeral joint in terms of efficiency and pain. Further trials should be conducted with larger sample sizes, which are accompanied with longer follow-ups to fully evaluate FARES method of reduction.
AVISO LEGAL
O conteúdo desta página destina-se apenas a fins informativos e não pretende substituir o aconselhamento, diagnóstico ou tratamento médico profissional. Se necessitar de tratamento médico, procure sempre o conselho do seu médico ou dirija-se ao serviço de urgência mais próximo. As opiniões, crenças e pontos de vista expressos pelos indivíduos no conteúdo encontrado nesta página não reflectem as opiniões, crenças e pontos de vista da OrthoEvidence.
0 de 4 artigos mensais GRATUITOS desbloqueados
