Diagnostic et prise en charge des luxations antérieures d'épaule en secours en montagne

Abstract : Introduction: The anterior shoulder dislocation is the most frequent one in the Emergencies and accident departement . Its in hospital management worker is well codified. In medical mountain rescue, some of the shoulder dislocation are maaged with no pre reduction Xrays. The main objective of our study was to assess the risk of an out hospital reduction.On a second hand , we tried to identify circonstances and clinical risk factor contraindicating reduction . Methology: We conducted a observational, retrospective study from January 1st, 2010 till December 31st, 2016 in Saint Denis, Reunion island upon the medical care of the shoulder dislocation in mountain rescue. Result: We included 52 patients in the study. Three of the 37 patients that had undergone an out-hospital reduction had a complexe fracture.30 patients were successfully reduced out of hospital. Nine of the15 patients who had not undergone out hospital reduction had a complex fracture. The age of the patients, a direct shock on the shoulder, other associated traumas and the sensation of crackle were situation signicantly more at risk of humeral fracture (p 0,05). Conclusion: The out-hospital diagnosis of simple anterior shoulder dislocation by the emergency physicians appears to be reliable. The reduction of shoulder dislocation with no pre-reduction Xrays doesn't seem to be harmful for the patient.
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Master Thesis
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Jonathan Cluzel. Diagnostic et prise en charge des luxations antérieures d'épaule en secours en montagne. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02001628⟩

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