Sofu Hakan, Gürsu Sarper, Koçkara Nizamettin, Oner Ali, Issın Ahmet, Camurcu Yalkın
Hakan Sofu, Nizamettin Koçkara, Ahmet Issın, Department of Orthopedics and Traumatology, Erzincan University Faculty of Medicine, 24030 Erzincan, Turkey.
World J Clin Cases. 2014 Nov 16;2(11):676-82. doi: 10.12998/wjcc.v2.i11.676.
The purpose of this review article is to discuss the clinical spectrum of recurrent traumatic anterior shoulder instability with the current concepts and controversies at the scientific level. Because of increasing participation of people from any age group of the population in sports activities, health care professionals dealing with the care of trauma patients must have a thorough understanding of the anatomy, patho-physiology, risk factors, and management of anterior shoulder instability. The risk factors for recurrent shoulder dislocation are young age, participation in high demand contact sports activities, presence of Hill-Sachs or osseous Bankart lesion, previous history of ipsilateral traumatic dislocation, ipsilateral rotator cuff or deltoid muscle insufficiency, and underlying ligamentous laxity. Achieving the best result for any particular patient depends on the procedure that allows observation of the joint surfaces, provides the anatomical repair, maintains range of motion, and also can be applied with low rates of complications and recurrence. Although various surgical techniques have been described, a consensus does not exist and thus, orthopedic surgeons should follow and try to improve the current evidence-based treatment modalities for the patients.
这篇综述文章的目的是在科学层面上讨论复发性创伤性前肩关节不稳定的临床范围以及当前的概念和争议。由于各年龄段人群参与体育活动的人数不断增加,处理创伤患者护理的医疗保健专业人员必须全面了解前肩关节不稳定的解剖结构、病理生理学、危险因素及治疗方法。复发性肩关节脱位的危险因素包括年轻、参与高需求的接触性体育活动、存在希尔-萨克斯损伤或骨性肩胛盂唇损伤、同侧既往创伤性脱位史、同侧肩袖或三角肌功能不全以及潜在的韧带松弛。对于任何特定患者,要取得最佳治疗效果取决于能观察关节面、进行解剖修复、保持活动范围且并发症和复发率低的手术方法。尽管已经描述了各种手术技术,但尚未达成共识,因此,骨科医生应遵循并努力改进目前基于证据的患者治疗方式。