Jaeger M, Izadpanah K, Maier D, Südkamp N P
Department Orthopädie und Traumatologie, Universitätsklinikum Freiburg, Hugstetter Strasse 55, Freiburg, Germany.
Chirurg. 2009 Jul;80(7):657-73; quiz 674. doi: 10.1007/s00104-009-1710-3.
Shoulder dislocations are a frequent event and the severity is often underestimated. A thorough clinical investigation and adapted imaging diagnostics are able to detect age-dependent injury patterns. A biphasic conservative treatment keeping the arm in a neutral to mild external rotation for 3 weeks has proven to be most effective and should be followed by an intensive physiotherapy. Nevertheless, conservative treatment protocols show unacceptable recurrence rates particularly in young men active in sport, therefore, surgical stabilisation is recommended. In the past open procedures were accepted as the gold standard, but today arthroscopic Bankart repair using suture anchors shows comparable recurrence rates. However, the clinical outcome with respect to the shoulder function is much better without compromising the subscapularis muscle.
肩关节脱位很常见，其严重程度常常被低估。全面的临床检查和适当的影像学诊断能够发现与年龄相关的损伤模式。已证明将手臂保持在中立至轻度外旋位3周的双相保守治疗最为有效，之后应进行强化物理治疗。然而，保守治疗方案的复发率高得令人难以接受，尤其是在从事体育运动的年轻男性中，因此，建议进行手术稳定治疗。过去，开放手术被视为金标准，但如今使用缝合锚钉的关节镜下Bankart修复术显示出相当的复发率。然而，在不影响肩胛下肌的情况下，肩关节功能的临床结果要好得多。
