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广义韧带松弛作为原发性创伤性前肩脱位的易患因素。

Generalized ligamentous laxity as a predisposing factor for primary traumatic anterior shoulder dislocation.

机构信息

University of Toronto, Toronto, ON, Canada.

出版信息

J Shoulder Elbow Surg. 2010 Dec;19(8):1238-42. doi: 10.1016/j.jse.2010.02.005. Epub 2010 May 8.

Abstract

HYPOTHESIS

The purpose of this study was to determine whether generalized ligamentous laxity and increased shoulder external rotation represent predisposing factors for primary traumatic anterior shoulder dislocation in young, active patients. We hypothesized that generalized ligamentous laxity and increased shoulder external rotation would be more common in individuals with first-time traumatic shoulder dislocations compared with controls.

MATERIALS AND METHODS

This retrospective case-control study examined hyperlaxity and shoulder external rotation >85° in 57 consecutive individuals (age <30 years) who sustained a primary traumatic anterior shoulder dislocation between 2003 and 2006. The Hospital Del Mar Criteria (battery of 10 clinical examination maneuvers) was used to measure generalized ligamentous laxity, which was determined to be present by overall scores exceeding 4/10 for men or 5/10 for women. The control group comprised 92 age-matched university students without a history of shoulder dislocation or anterior cruciate ligament injury.

RESULTS

Generalized ligamentous laxity was present in 33.3% of the cases compared with 15.2% of controls (P = .014). Increased contralateral shoulder external rotation (>85°) was observed in 38.6% of the study group compared with 22.8% of controls (P = .043). Men who had dislocated their shoulder were 6.8 times more likely to demonstrate generalized ligamentous laxity and increased shoulder external rotation compared with age and sex matched controls (P = .003).

DISCUSSION

Identifying hyperlax individuals may allow for shoulder-specific proprioceptive training.

CONCLUSION

Generalized joint laxity and increased external rotation in the contralateral shoulder were more common in patients who had sustained a primary shoulder dislocation.

摘要

假设

本研究的目的是确定广泛性韧带松弛和肩关节外旋增加是否代表年轻、活跃的初次创伤性肩关节前脱位患者的易患因素。我们假设与对照组相比,初次创伤性肩关节脱位患者的广泛性韧带松弛和肩关节外旋增加更为常见。

材料和方法

这项回顾性病例对照研究检查了 2003 年至 2006 年间连续 57 例(年龄<30 岁)初次创伤性肩关节前脱位患者的过度松弛和肩关节外旋>85°。采用 Del Mar 医院标准(10 项临床检查动作的测试组合)测量广泛性韧带松弛,男性总分超过 4/10,女性总分超过 5/10 即可判断为阳性。对照组由 92 名年龄匹配的、无肩关节脱位或前交叉韧带损伤史的大学生组成。

结果

病例组中广泛性韧带松弛的发生率为 33.3%,对照组为 15.2%(P=0.014)。研究组中有 38.6%的患者对侧肩关节外旋增加(>85°),而对照组为 22.8%(P=0.043)。与年龄和性别匹配的对照组相比,肩部脱位的男性发生广泛性韧带松弛和肩关节外旋增加的可能性高 6.8 倍(P=0.003)。

讨论

识别过度松弛的个体可能有助于进行肩关节特定的本体感觉训练。

结论

初次肩关节脱位患者中,广泛性关节松弛和对侧肩关节外旋增加更为常见。

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