Porcellini Giuseppe, Caranzano Francesco, Campi Fabrizio, Pellegrini Andrea, Paladini Paolo
Unit of Shoulder and Elbow Surgery, D. Cervesi Hospital, Cattolica, Italy.
Sports Med Arthrosc Rev. 2011 Dec;19(4):395-400. doi: 10.1097/JSA.0b013e31820d583b.
The prevalence of rotator cuff tears after traumatic dislocation increases with advancing age, a likely consequence of the age-associated deterioration of the structure and mechanical properties of the tendons of the rotator cuff. These are the effective stabilizers of the glenohumeral joint, compressing the humeral head in the 3-dimensional concavity of the glenohumeral joint. It is impossible to establish whether a lesion of the capsular-labrum complex or of the rotator cuff causes or follows a dislocation, regardless of whether it is anterior or posterior. A peripheral nerve or a brachial plexus injury can be associated with tendon lesion and instability, developing the "terrible triad" of the shoulder. Both conservative and surgical management are possible, and surgeons must choose the most appropriate management modality according to the biologic age, functional demands, and type of lesion.
创伤性肩关节脱位后肩袖撕裂的发生率随年龄增长而增加，这可能是肩袖肌腱结构和力学性能随年龄退化的结果。肩袖是盂肱关节的有效稳定器，可将肱骨头压缩在盂肱关节的三维凹面内。无论肩关节脱位是前脱位还是后脱位，都无法确定关节囊-盂唇复合体或肩袖损伤是导致脱位还是脱位后发生的。周围神经或臂丛神经损伤可能与肌腱损伤和不稳定相关，进而形成肩部的“可怕三联征”。保守治疗和手术治疗都是可行的，外科医生必须根据生物学年龄、功能需求和损伤类型选择最合适的治疗方式。
