Department of Orthopaedic Surgery, The University of Pennsylvania, Philadelphia, PA, USA.
Phys Sportsmed. 2011 May;39(2):149-57. doi: 10.3810/psm.2011.05.1906.
The shoulder joint has a wide range of motion as a result of a complex interplay of soft tissue and bone structures. It is also the most frequently dislocated joint in the body. Shoulder dislocations are generally classified as traumatic and nontraumatic. There are many specific causes, each of which necessitate individualized treatment modalities. Accurate diagnosis requires a careful history and physical examination. Arthroscopic surgery and advances in imaging have expanded our understanding of anatomy and pathology relevant to shoulder instability and its treatment. Surgery is the treatment of choice for recurrent traumatic instability. Surgery may also be indicated in some first-time traumatic dislocations in young contact athletes, whereas rehabilitation is the initial treatment of choice in older patients with initial instability and in those with nontraumatic dislocations. Results of arthroscopic capsulolabral repair now equal those of open capsulolabral repair and have become the surgical treatment of choice for most patients. However, in cases of recurrent instability and significant bone deficiency of either the glenoid or humeral head, open bone reconstructive procedures are often necessary to ensure successful outcomes.
肩关节具有广泛的运动范围，这是由于软组织和骨骼结构的复杂相互作用。它也是身体中最常脱位的关节。肩关节脱位一般分为创伤性和非创伤性。有许多特定的原因，每种原因都需要个体化的治疗方法。准确的诊断需要仔细的病史和体格检查。关节镜手术和影像学的进步扩展了我们对与肩关节不稳定及其治疗相关的解剖和病理学的理解。手术是复发性创伤性不稳定的治疗选择。对于年轻接触运动员的初次创伤性脱位，有时也需要手术，而对于初次不稳定和非创伤性脱位的老年患者，康复是初始治疗的首选。关节镜下囊唇修复的结果现在与开放性囊唇修复的结果相当，并且已成为大多数患者的手术治疗选择。然而，在复发性不稳定和肩盂或肱骨头明显骨缺损的情况下，通常需要进行开放性骨重建手术以确保获得成功的结果。
