LUXAÇÕES DO OMBRO: EPIDEMOLOGIA, ASPECTOS CLÍNICOS E TERAPÊUTICA

Autores

  • Eduardo Henrique Soares Almeida Centro Universitário do Planalto Central Apparecido dos Santos (UNICEPLAC)
  • Carlos Augusto Abdo dos Santos Universidade do Oeste Paulista (UNOESTE)
  • Lucas Matsunaga Medeiros Centro Universitário Ingá (UNINGÁ)
  • Victor Hugo de Souza Bona Universidade do Sul de Santa Catarina (UNISUL)
  • Antônio Francisco Ruaro Filho Universidade Luterana do Brasil (ULBRA)

DOI:

https://doi.org/10.25110/arqsaude.v27i10.2023-017

Palavras-chave:

Deslocamento, Ombro, Técnica de Redução

Resumo

A luxação anterior do ombro é comumente observada em clínicas de acidentes e emergências e trauma e postos de saúde. Neste estudo, revisamos a literatura existente sobre a lesão e as tendências recentes no manejo. Descrevemos a anatomia clínica do ombro, o diagnóstico e as técnicas de redução. As decisões de manejo em relação a esta condição continuam a variar entre as unidades, especialmente para casos recorrentes e posteriores luxação. A luxação do ombro é uma lesão comum. Os atrasos no diagnóstico continuam a ser o maior obstáculo para uma otimização dos resultados neste grupo de pacientes. Uma proporção significativa necessitará de eventual cirurgia e até um terço destes pacientes irão desenvolver artrite no ombro a longo prazo. A técnica escolhida para a redução, dependerá do conhecimento do médico, que já deve estar familiarizado com a técnica adotada, pois a perfeição na realização da resolução do problema, trará conforto e alivio ao paciente, já que mesmo os pacientes que sofreram um único episódio de luxação podem continuar desenvolver sequelas a longo prazo.

Referências

ABRAMS, R.; AKBARNIA, H. Shoulder Dislocations Overview. Treasure Island (FL): StatPearls Publishing, 2023. [online]

ALKADUHIMI, H. et al. A systematic and technical guide on how to reduce a shoulder dislocation. Turk J Emerg Med, v. 16, n. 4, p. 155-168, 2016.

ALKADUHIMI, H. et al. A systematic comparison of the closed shoulder reduction techniques. Arch Orthop Trauma Surg, v. 137, n. 5. p. 589-599, 2017.

ANJUM, R. et al. Reducing shoulder dislocation without anaesthesia or assistant: Validation of a new reduction manoeuvre. Chin J Traumato, v. 22, n. 5, p. 274-277, 2019.

ASSUNÇÃO, J. Afecções do ombro em ambulatório: Um estudo epidemiológico. 2020. Disponível em: https://ortopediaeombro.com.br/afeccoes-do-ombro-em-ambulatorio-um-estudo-epidemiologico/.

BACKER, M,; WARREN, R . Glenohumeral instabilities. In: DeLEE, J,; DREZ, D,; MILLER, M. (Eds).. DeLee and Drez’s Orthopaedic Sports Medicine Principles and Practice. Philadelphia: WB Saunders, 2003. p. 1020–1034.

BAKHSH, W,; NICANDRI, G. Anatomy and Physical Examination of the Shoulder. Sports Med Arthrosc Rev, v. 26, n. 3, p. e10-e22, 2018.

BAYKAL, B.; SENER, S.; TURKAN, H. Scapular manipulation technique for reduction of traumatic anterior shoulder dislocations: experiences of an academic emergency department. Emerg Med J, v. 22, n. 5, p. 336-338, 2005.

BLAKELEY, C. J. et al. A novel use of portable ultrasound in the management of shoulder dislocation. Emerg Med J, v. 26, n. 9, p. 662-663, 2009.

BONZ, J.; TINLOY, B. Emergency department evaluation and treatment of the shoulder and humerus. Emerg Med Clin North Am, v. 33, n. 2, p. 297-310, 2015.

BOZKURT, M.; AÇAR, H. I. (Eds.) Clinical Anatomy of the Shoulder: An Atlas. Berlin: Springer, 2017. 94 p.

BRAUN, C.; McROBERT, C. J. Conservative management following closed reduction of traumatic anterior dislocation of the shoulder. Cochrane Database Syst Rev, v. 5, n. 5, D004962, 2019,

BROWNSON, P. et al. BESS/BOA Patient Care Pathways: Traumatic anterior shoulder instability. Shoulder & Elbow, v. 7, n. 3, p. 214-226, 2015.

CARRAZZONE, O. L. et al. Prevalência das lesões associadas na luxação recidivante traumática do ombro. Rev. Bras. Ortop, v. 46, n. 3, p. 281-287, 2011.

CHAMSEDDINE, A. H. et al. FARES method for reduction without medication of first episode of traumatic anterior shoulder dislocation. Int Orthop, v. 43, n. 5, p. 1165-1170, 2019.

CICAK, N . Posterior dislocation of the shoulder. J Bone Joint Surg Br, v. 86, n. 3, p. 324-332, 2004.

COWAN, P. T.; MUDREAC, A.; VARACALLO, M. Anatomy, Back, Scapula. Treasure Island, FL: StatPearls Publishing. 2023.

CUNNINGHAM, N. A new drug free technique for reducing anterior shoulder dislocations. Emerg Med v. 15, n. 5-6, p. 521-524, 2003.

CUTTS, S.; PREMPEH, M.; DREW, S. Anterior Shoulder Dislocation. Ann R Coll Surg Engl, v. 91, n. 1, p. 2-7, 2009.

DEVI, V. S. Inderbir Singh's Human Embryology. 11. ed. Nova Deli: Jaypee Brothers Medical Pub. 2017, 351 P.

DONG, H.; JENNER, E. A.; THEIVENDRAN, K. Closed reduction techniques for acute anterior shoulder dislocation: a systematic review and meta-analysis. Eur J Trauma Emerg Surg, v. 47, n. 2, p. 407-421, 2021.

EACHEMPATI, K. K. et al. The external rotation method for reduction of acute anterior dislocations and fracture-dislocations of the shoulder. J Bone Joint Surg Am, v. 86, n. 11, p. 2431-2434, 2004.

ECHLIN, P. S.; MICHAELSON, J. E . Adolescent butterfly swimmer with bilateral subluxing sternoclavicular joints. Br J Sports Med, v. 40, n. 4, p. 1-4, 2006.

FINNOFF, J. T,; DOUCETTE, S.; HICKEN, G . Glenohumeral instability and dislocation. Phys Med Rehabil Clin N Am, v. 15, p. 575-605, 2004.

GASKILL, T. R.; TAYLOR, D. C.; MILLETT, P. J. Management of multidirectional instability of the shoulder. J Am Acad Orthop Surg, v. 19, n. 12, p. 758-767, 2011.

GOTTLIEB, M. Current approach to the diagnosis and management of shoulder dislocation in children. Pediatr Emerg Care, v. 34, n. 5, p. 357-362, 2018.

GOTTLIEB, M. Shoulder Dislocations in the Emergency Department: A Comprehensive Review of Reduction Techniques. J Emerg Med, v. 58, n. 4, p. 647-666, 2020.

GULER, O. et al. Comparison of four different reduction methods for anterior dislocation of the shoulder. J Orthop Surg Res, v. 10, p. 1-7, 2015.

HALBERG, M. J.; SWEENEY, T. W.; OWENS, W. B. Bedside ultrasound for verification of shoulder reduction. Am J Emerg Med, v. 27, n. 1, p. 134-136, 2009.

HUROV, J. Anatomy and mechanics of the shoulder: review of current concepts. J Hand Ther. 2009;22(4):328-342. (Review article)

JANITZKY, A. A, et al. Anterior Shoulder Dislocations in Busy Emergency Departments: The External Rotation Without Sedation and Analgesia (ERWOSA) Method May Be the First Choice for Reduction. Medicine, v. 94, m. 47, p. e1852, 2015.

KERN, D. E. Shoulder and Elbow Pain. In: FIEBACH, N. H. et al (Eds). Principles of ambulatory medicine. 7. ed. Philadelphia: Lippincott Williams & Wilkins, 2007. capitulo 69.

KUMAR, V. P. Biomechanics of the shoulder. Ann Acad Med Singap, v. 31, n. 5, p. 590-592, 2002.

LORENTE, A. et al. Nerve Injuries after Glenohumeral Dislocation, a Systematic Review of Incidence and Risk Factors. J Clin Med, v. 12, n. 13, e4546, 2023.

MACKENZIE, D. C.; LIEBMANN, O. Point-of-care ultrasound facilitates diagnosing a posterior shoulder dislocation. J Emerg Med, v. 44, n. 5, p. 976-978, 2013.

MATTICK, A.; WYATT, J. P. From Hippocrates to the Eskimo--a history of techniques used to reduce anterior dislocation of the shoulder. J R Coll Surg Edinb, v. 45, n. 5, p. 312-316, 2000.

MAWEJA, S. et al. Axillary artery injury secondary to anterior shoulder dislocation: report of two cases. Acta Chir Belg, v. 102, n. 3, p. 187-191, 2002.

MINIATO, M. A.; ANAND, P.; VARACALLO, M. Anatomy, Shoulder and Upper Limb, Shoulder. Treasure Island (FL): StatPearls Publishing, 2023. [Online].

NAMBIAR, M. et al. Traumatic inferior shoulder dislocation: a review of management and outcome. Eur J Trauma Emerg Surg, v. 44, n. 1, p. 45-51, 2018.

NAZARI, E. M.; MÜLLER, Y. M. R. Embriologia humana. Florianópolis : BIOLOGIA/EAD/UFSC, 2011. 170 p.

O'CONNOR, D. R. et al. Painless reduction of acute anterior shoulder dislocations without anesthesia. Orthopedics, v. 29, n. 6, p. 528-532, 2006.

PESCATORE, R.; NYCE, A. Managing Shoulder Injuries in the Emergency Department: Fracture, Dislocation, and Overuse. Emerg med pract, v. 20, n. 1, p. 1-28, 2018.

PISHBIN, E.; BOLVARDI, E. AHMADI, K. Scapular manipulation for reduction of anterior shoulder dislocation without analgesia: results of a prospective study. Emerg Med Australas, V. 23, N. 1, P. 54-58, 2011.

ROBINSON, C. M. et al. Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation inyoung patients. J Bone Joint Surg Am, v. 88, n. 11, p. 2326-2336, 2006.

SHAH, R. et al. Pitch-side management of acute shoulder dislocations: a conceptual review. BMJ open sports& exercise medicine, v. 2, n. 1, p. 1-9, 2017.

SINEFF, S. S.; REICHMAN, E. F. Shoulder joint dislocation reduction. In: Emergency Medicine Procedures. REICHMAN, E. F.; SIMON, R. R (Eds). Nova Iorque: McGraw-Hill, 2004. 1344 p.

SITHAMPARAPILLAI, A. et al. Intra-articular lidocaine versus intravenous sedation for closed reduction of acute anterior shoulder dislocation in the emergency department: a systematic review and meta-analysis. CJEM, v. 24, p. 809-819, 2022.

STAFYLAKIS, D.; ABRASSART, S.; HOFFMEYER, P. Reducing a Shoulder Dislocation Without Sweating. The Davos Technique and its Results. Evaluation of a Nontraumatic, Safe, and Simple Technique for Reducing Anterior Shoulder Dislocations. J Emerg Med, v. 50, n. 4, p. 656-659, 2016.

TANNENBAUM, E.; SEKIYA, J. K. Evaluation and management of posterior shoulder instability. Sports Health, v. 3, p. 253-263, 2011.

WANG, V. M.; FLATOW, E. L. Pathomechanics of acquired shoulder instability: a basic science perspective. J Shoulder Elbow Surg, v. 14, p. S2-S11, 2005.

YAO, L. et al. Ultrasound-guided interscalene block versus intravenous analgesia and sedation for reduction of first anterior shoulder dislocation. Am. J. Emerg. Med, v. 56, p. 232-235, 2022.

YESIL, O. et al. Which Comes First in Posterior Shoulder Dislocation; X-Ray or Computed Tomography? Akatos, v. 3, n. 1, p. 12-14, 2012.

YOUM, T.; TAKEMOTO, R.; PARK, B. K. Acute Management of Shoulder Dislocations. Journal of the AAOS, v. 22, n. 12, p. 761-771, 2014.

ZACCHILLI, M. A.; OWENS, B. D. Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg Am, v. 92, p. 542-549, 2010.

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Publicado

23-10-2023

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ALMEIDA, Eduardo Henrique Soares; DOS SANTOS , Carlos Augusto Abdo; MEDEIROS , Lucas Matsunaga; BONA , Victor Hugo de Souza; RUARO FILHO, Antônio Francisco. LUXAÇÕES DO OMBRO: EPIDEMOLOGIA, ASPECTOS CLÍNICOS E TERAPÊUTICA. Arquivos de Ciências da Saúde da UNIPAR, [S. l.], v. 27, n. 10, p. 5722–5738, 2023. DOI: 10.25110/arqsaude.v27i10.2023-017. Disponível em: https://unipar.openjournalsolutions.com.br/index.php/saude/article/view/10682. Acesso em: 22 dez. 2024.

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