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[创伤性肩袖损伤的诊断与专家评估建议]

[Recommendations for diagnosis and expert assessment of traumatic rotator cuff lesions].

作者信息

Loew M, Habermeyer P, Wiedemann E, Rickert M, Gohlke F

机构信息

Sektion für Orthopädie der Schulter und des Ellbogens, Stiftung Orthopädische Universitätsklinik Heidelberg.

出版信息

Unfallchirurg. 2000 May;103(5):417-26. doi: 10.1007/s001130050560.

Abstract

Traumatic rotator cuff lesions are a very rare condition. However, this article represents a comprehensive survey according to current knowledge on anatomy, biomechanics, and pathogenesis of rotator cuff pathology. Because of the relatively high prevalence of degenerative changes with increasing age, including partial and complete rotator cuff tears, it may be difficult to demonstrate the causality of an acute traumatic rotator cuff tear. Therefore, a catalogue of potential adequate and inadequate trauma mechanisms is proposed. Emphasis is also placed on posttraumatic diagnostic steps following persistent rotator cuff deficient shoulder function (e.g., ultrasound, MRI). From a legal aspect (e.g., private accident insurance, workers compensation claim), different minor and major criteria are defined, which could help experts to judge the causality of posttraumatic rotator cuff deficiency. These criteria mainly refer to distinct details concerning patients' history, trauma mechanism, primary clinical appearance, and diagnostic findings.

摘要

创伤性肩袖损伤是一种非常罕见的病症。然而,本文依据目前关于肩袖病理的解剖学、生物力学及发病机制的知识进行了全面综述。由于随着年龄增长退行性改变(包括部分和完全性肩袖撕裂)的发生率相对较高,可能难以证实急性创伤性肩袖撕裂的因果关系。因此,提出了一份潜在的充分和不充分创伤机制目录。还强调了肩袖功能持续缺失后(如超声、磁共振成像)的创伤后诊断步骤。从法律层面(如私人意外保险、工伤赔偿申请)定义了不同的次要和主要标准,这有助于专家判断创伤后肩袖功能缺失的因果关系。这些标准主要涉及患者病史、创伤机制、初始临床表现及诊断结果的不同细节。

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