Ochs B G, Rickert M, Schmelzer-Schmied N, Loew M, Thomsen M
Orthopädische Universitätsklinik Heidelberg.
Orthopade. 2005 Feb;34(2):152-8. doi: 10.1007/s00132-004-0720-6.
Post-traumatic shoulder instability in adolescence represents a very rare condition. However, most of these patients develop recurrent shoulder dislocations over time.
We report about a retrospective study, which included 32 patients younger than 16 years of age. The mean follow-up was 5 years. Our evaluation focussed on patients' age at the time of first shoulder dislocation, type of injury, and the results after conservative and operative treatment.
After the first dislocation, all shoulders were immobilized for 3 weeks and were treated with physiotherapy afterwards. Of these 32 patients, 30 (94%) developed recurrent shoulder dislocations. Eight patients remained in a conservative regimen (age <15 years) and 21 patients were operated for persistent shoulder instability (age >15 years). The recurrence rate was 8 of 21 patients (36.5%) in the operative group and 4 of 8 patients in the conservative group. At the time of follow-up, 4 of 8 conservatively treated patients had returned to their former sports activities and 15 of 21 (71%) in the operated group.
Our results on post-traumatic shoulder instability in adolescence show high recurrence rates in both conservative and operative groups. After adolescence, including ossification of the glenoid, operative treatment is able to decrease the recurrence rate and to increase the sports ability of these young patients.
青少年创伤后肩关节不稳定是一种非常罕见的病症。然而，随着时间的推移，这些患者中的大多数会出现复发性肩关节脱位。
我们报告了一项回顾性研究，该研究纳入了32名年龄小于16岁的患者。平均随访时间为5年。我们的评估重点是首次肩关节脱位时患者的年龄、损伤类型以及保守治疗和手术治疗后的结果。
首次脱位后，所有肩关节均固定3周，之后接受物理治疗。在这32名患者中，30名（94%）出现了复发性肩关节脱位。8名患者采用保守治疗方案（年龄<15岁），21名患者因持续性肩关节不稳定接受了手术治疗（年龄>15岁）。手术组21名患者中有8名（36.5%）复发，保守组8名患者中有4名复发。在随访时，8名接受保守治疗的患者中有4名恢复了以前的体育活动，手术组21名患者中有15名（71%）恢复了体育活动。
我们关于青少年创伤后肩关节不稳定的研究结果表明，保守治疗组和手术治疗组的复发率都很高。青春期后，包括肩胛盂骨化后，手术治疗能够降低复发率并提高这些年轻患者的运动能力。
