Department of Orthopedic Sports Surgery, Klinikum Rechts der Isar, Technische Universitaet, Connollystrasse 32, Munich, Germany.
Int Orthop. 2010 Oct;34(7):1049-58. doi: 10.1007/s00264-010-1038-0. Epub 2010 May 19.
During throwing motion the athlete puts enormous stress on both the dynamic and the static stabilisers of the shoulder. Repetitive forces cause adaptive soft tissue and bone changes that initially improve performance but ultimately may lead to shoulder pathologies. Although a broad range of theories have been suggested for the pathophysiology of internal impingement, the reasons are obviously multifactorial. This review aims to critically analyse the current literature and to summarise clinically important information. The cardinal lesions of internal impingement, articular-sided rotator cuff tears and posterosuperior labral lesions, have been shown to occur in association with a number of other findings, most importantly glenohumeral internal rotation deficit and SICK scapula syndrome, but also with posterior humeral head lesions, posterior glenoid bony injury and, rarely, with Bankart and inferior glenohumeral ligament lesions. Extensive biomechanical and clinical research is necessary before a complete understanding and reconciliation of the varying theories of the pathomechanisms of injury can be developed.
在投掷运动中，运动员的肩部会承受巨大的动态和静态稳定器的压力。反复的力量会导致适应性的软组织和骨骼变化，这些变化最初会提高表现，但最终可能导致肩部病变。虽然已经提出了广泛的理论来解释内部撞击的病理生理学，但原因显然是多因素的。本篇综述旨在批判性地分析当前的文献，并总结临床相关信息。已经证实，内部撞击的主要病变，关节侧旋转袖撕裂和后上盂唇病变，与许多其他发现有关，最重要的是肩肱关节内旋不足和 SICK 肩胛骨综合征，但也与肱骨头后病变、盂后骨损伤以及很少见的 Bankart 和下盂肱韧带病变有关。在完全理解和协调损伤的病理机制的各种理论之前，需要进行广泛的生物力学和临床研究。
