Department of Orthopaedic Surgery, Division of Sports Medicine and Shoulder and Elbow Surgery, Boston University School of Medicine, Boston, MA, USA.
J Am Acad Orthop Surg. 2013 Sep;21(9):529-37. doi: 10.5435/JAAOS-21-09-529.
Several studies have focused on management of shoulder instability in the adolescent and young adult population. However, a paucity of literature exists regarding shoulder dislocation in the skeletally immature population. The presence of an open physis makes the dislocated pediatric shoulder a challenging clinical problem. In general, management includes prompt reduction and sling immobilization. In athletic patients aged ≥14 years with a Bankart lesion, early surgical intervention may be warranted because of the higher risk of recurrent instability. However, the literature on younger skeletally immature patients is less clear in terms of risk of further instability and the necessity of surgical intervention. In the skeletally immature population, a relatively low rate of recurrent instability after primary dislocation has been reported in the recent literature. Surgical intervention should be considered for patients with recurrent instability.
已有多项研究集中于青少年和年轻成年人的肩关节不稳定的处理。然而，对于骨骼未成熟人群的肩关节脱位，文献仍然较少。骺板未闭使得儿童肩关节脱位成为具有挑战性的临床问题。一般而言，处理方法包括及时复位和吊带固定。对于年龄≥14 岁、存在 Bankart 损伤的运动员患者，可能需要早期手术干预，因为其复发性不稳定的风险较高。然而，在骨骼未成熟的年轻患者中，关于进一步不稳定的风险和手术干预的必要性，文献报道并不明确。在骨骼未成熟人群中，近期文献报道初次脱位后复发性不稳定的相对发生率较低。对于复发性不稳定的患者，应考虑手术干预。
