Mohtadi N G
Faculty of Medicine, University of Calgary, Alberta, Canada.
Clin Sports Med. 1991 Oct;10(4):863-70.
Anterior instability involves a spectrum of disease ranging from the obvious acute first-time dislocation to the athlete presenting with shoulder pain and no history suggestive of instability. It is important to recognize the pathophysiology and how it relates to this spectrum of disease. The arthroscope has helped to identify the underlying pathology in both acute and chronic situations. Diagnostically, a history of a painful shoulder, especially in the athlete, should suggest anterior instability. Tests of translation, apprehension, and the use of local anesthetic can be useful. Arthroscopy is used in situations in which the diagnosis is unclear. The management of anterior instability should emphasize strengthening of the rotator cuff and scapular stabilizers. Surgical repair requires correction of the underlying pathology with minimization of damage to other structures. Arthroscopic management of anterior instability includes repair, debridement of intra-articular lesions, and the possibility of acute correction of the pathoanatomic lesions.
前方不稳定涉及一系列疾病，范围从明显的急性首次脱位到出现肩部疼痛且无不稳定病史的运动员。认识其病理生理学以及它与这一系列疾病的关系很重要。关节镜有助于识别急性和慢性情况下的潜在病理。在诊断方面，肩部疼痛的病史，尤其是运动员的，应提示前方不稳定。平移试验、恐惧试验以及局部麻醉的使用可能有用。当诊断不明确时使用关节镜检查。前方不稳定的治疗应强调加强肩袖和肩胛稳定肌。手术修复需要纠正潜在病理，同时尽量减少对其他结构的损伤。前方不稳定的关节镜治疗包括修复、清理关节内病变以及对病理解剖病变进行急性纠正的可能性。
