Heinzelmann Andrew D, Savoie Felix H
Mississippi Sports Medicine and Orthopaedic Center, Jackson, Mississippi, USA.
Instr Course Lect. 2009;58:315-21.
The shoulder is an inherently unstable joint that is subject to different patterns of instability. Determining the direction of subluxation that is causing the patient's symptoms can be difficult. Although posterior and multidirectional instability share many characteristics, they have different etiologies and treatment requirements. Multidirectional instability was first described in 1980 by Neer and Foster, but the continuing lack of a consistent definition for the condition contributes to difficulty in both diagnosis and treatment. Posterior instability has been more precisely defined, but the diagnosis nonetheless can be difficult. For most patients with either condition, rehabilitation and bracing are the preferred treatment. If nonsurgical treatment is unsuccessful, arthroscopic treatment can provide a satisfactory result.
肩关节本质上是一个不稳定的关节，易出现不同类型的不稳定情况。确定导致患者症状的半脱位方向可能很困难。尽管后方不稳定和多方向不稳定有许多共同特征，但它们的病因和治疗要求不同。多方向不稳定于1980年由尼尔和福斯特首次描述，但对该病症一直缺乏统一的定义，这导致诊断和治疗都存在困难。后方不稳定已有更精确的定义，但诊断仍然可能很困难。对于大多数患有这两种病症的患者，康复治疗和支具固定是首选治疗方法。如果非手术治疗不成功，关节镜治疗可以提供满意的效果。
