Department of Orthopedic Sports Medicine, Technical University, Munich, Germany.
Arthroscopy. 2011 Nov;27(11):1562-72. doi: 10.1016/j.arthro.2011.06.015. Epub 2011 Sep 1.
Posterior shoulder dislocations (PSDs) comprise a small subset of shoulder dislocations, and there are few evidence-based treatment protocols and no actual algorithm for the treatment of PSDs available in the literature. This article provides a systematic review of the literature, as well as an overview of clinical and radiologic diagnostic techniques, and presents an algorithm for treatment of PSDs, including minimally invasive treatment options.
For a systematic review of current literature, a systematic search was performed in the Medline and Cochrane databases. Journal articles published between January 1940 and June 2010 were taken into account. Studies that only existed as abstracts were not included in the analysis. Broad exclusion criteria consisted of radiologic reports, review articles, case reports, and technical notes. Refined exclusion criteria consisted of a minimum of 4 patients with PSDs operated on by the same surgical technique and clinical outcome documented by a functional shoulder score.
The final set of articles for evaluating closed or open techniques included 5 prospective case series and 6 retrospective studies. Within this group, there was no study with a level of evidence higher than Level IV. We present a descriptive comparison of these studies because of the heterogeneity and/or number of patients and the level of evidence. Case reports illustrate the different surgical approaches according to the literature.
PSDs are still a challenge for the treating physician. There are few articles available about PSDs in evidence-based literature, with a limited number of cases. Our algorithm provides guidelines for decision making including minimally invasive treatment options according to the available literature.
Level IV, systematic review of Level IV studies.
肩后脱位（PSD）是肩脱位的一小部分，文献中几乎没有基于证据的治疗方案，也没有实际的 PSD 治疗算法。
本文对文献进行了系统回顾，概述了临床和放射诊断技术，并提出了 PSD 治疗的算法，包括微创治疗选择。
为了对现有文献进行系统评价，在 Medline 和 Cochrane 数据库中进行了系统搜索。
考虑了 1940 年 1 月至 2010 年 6 月期间发表的期刊文章。
仅作为摘要存在的研究未包括在分析中。
广泛的排除标准包括放射报告、综述文章、病例报告和技术说明。
精炼的排除标准包括至少 4 例 PSD 患者采用相同手术技术治疗，以及通过功能肩部评分记录临床结果。
评估闭合或开放技术的最终文章集包括 5 项前瞻性病例系列和 6 项回顾性研究。
在这一组中，没有证据水平高于 IV 级的研究。
由于异质性和/或患者数量以及证据水平，我们对这些研究进行了描述性比较。
病例报告根据文献说明了不同的手术方法。
PSD 仍然是治疗医生的挑战。
基于证据的文献中关于 PSD 的文章很少，病例也很少。
我们的算法根据现有文献提供了包括微创治疗选择在内的决策指南。
IV 级，对 IV 级研究的系统评价。
