Elite Sports Medicine, Connecticut Children's Medical Center, 399 Farmington Avenue, Farmington, CT 06032, USA; University of Connecticut School of Medicine, Farmington, CT, USA.
Clin Sports Med. 2013 Oct;32(4):761-79. doi: 10.1016/j.csm.2013.07.010.
Instability of the shoulder is a common issue faced by sports medicine providers caring for pediatric and adolescent patients. A thorough history and physical examination can help distinguish traumatic instability from multidirectional or voluntary instability. A systematic understanding of the relevant imaging characteristics and individual patient disease and goals can help guide initial treatment. Given the high risk of recurrent instability, young, active patients who seek to return to competitive contact sports should consider arthroscopic stabilization after a first-time instability event. MDI should be treated initially with conservative rehabilitation. Patients who fail extensive conservative treatment may benefit from surgical stabilization. Arthroscopic techniques may now approach the results found from traditional open capsular shift procedures. Future studies should be designed to examine the outcomes in solely pediatric and adolescent populations after both conservative and operative treatment of shoulder instability.
肩部不稳定是运动医学提供者在照顾儿科和青少年患者时经常面临的问题。详细的病史和体格检查有助于区分创伤性不稳定与多向性或自主性不稳定。系统了解相关的影像学特征以及个体患者的疾病和目标有助于指导初始治疗。鉴于复发性不稳定的高风险，寻求重返竞技接触性运动的年轻、活跃患者应在首次不稳定事件后考虑关节镜下稳定术。MDI 最初应采用保守康复治疗。广泛保守治疗失败的患者可能受益于手术稳定。关节镜技术现在可以达到传统开放性囊袋移位手术的结果。未来的研究应设计来检查在保守和手术治疗肩部不稳定后仅在儿科和青少年人群中的结果。
