Srinivasan Suresh, Pandey Radhakant
Upper Limb Unit, Department of Trauma and Orthopaedic Surgery, Musculoskeletal Directorate, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, UK.
Indian J Orthop. 2017 Sep-Oct;51(5):524-528. doi: 10.4103/ortho.IJOrtho_224_17.
Shoulder instability ranges from subtle instability to frank dislocation. Our understanding on the subject is getting better. Patient lifestyle, increased awareness/expectations, better availability of information, improved imaging modalities, and increased awareness about the previously less known concepts in instability all add to the challenges of managing the problem. History and clinical examination without over reliance on imaging remain essential. We used Embase, PubMed, Medline, CINAHL, Cochrane Library, Scottish Intercollegiate Guidelines Network and Google Scholar search for published literature in English. We used various combinations of the keywords, namely, human shoulder instability, sports injuries, dislocation, surgery, latarjet, glenohumeral, glenoid, and arthroscopy from 1980 to March 2017. The systematic search captured 310 publications. After applying initial exclusion criteria, 41 abstracts were assessed for eligibility. Of these, we selected 20 full-text articles with the majority of focus primarily on surgical management of traumatic shoulder instability. A tailor-made approach for the management of the individual patient is essential and should involve shared decision making. In this article, we have tried to simplify and present the current evidence in the management of traumatic shoulder instability, particularly in sportsperson.
肩部不稳定的程度从轻微不稳定到明显脱位不等。我们对这个问题的理解正在不断加深。患者的生活方式、意识/期望的提高、信息获取的便利性增加、成像方式的改进以及对以前鲜为人知的不稳定概念的认识提高,都增加了处理这个问题的挑战。病史和临床检查而不过度依赖成像仍然至关重要。我们使用Embase、PubMed、Medline、CINAHL、Cochrane图书馆、苏格兰校际指南网络和谷歌学术搜索1980年至2017年3月期间以英文发表的文献。我们使用了各种关键词组合,即人类肩部不稳定、运动损伤、脱位、手术、Latarjet手术、盂肱关节、肩胛盂和关节镜检查。系统检索共获得310篇出版物。应用初步排除标准后,对41篇摘要进行了资格评估。其中,我们选择了20篇全文文章,大多数主要关注创伤性肩部不稳定的手术治疗。针对个体患者量身定制的治疗方法至关重要,且应包括共同决策。在本文中,我们试图简化并呈现创伤性肩部不稳定管理方面的当前证据,尤其是在运动员中。