后肩部不稳定：自然病史、临床评估与影像学表现
The Posterior Unstable Shoulder: Natural History, Clinical Evaluation and Imaging.
作者信息
Díaz Heredia Jorge, Ruiz Iban Miguel Angel, Ruiz Diaz Raquel, Moros Marco Santos, Gutierrez Hernandez Juan Carlos, Valencia Maria
机构信息
Unidad de Hombro y Codo. Servicio de Traumatología y Cirugía Ortopédica. Hospital Universitario Ramón y Cajal, Madrid, Spain.
Servicio de Traumatología y Cirugía Ortopédica, Clínica MAZ, Zaragoza, Spain.
出版信息
Open Orthop J. 2017 Aug 31;11:972-978. doi: 10.2174/1874325001711010972. eCollection 2017.
BACKGROUND
There is a low incidence of posterior instability which is present in only 2% to 10% of all unstable shoulders. The posterior instable shoulder includes different manifestations like fixed dislocation, recurrent subluxation or dislocation.
METHODS
Research and online content related to posterior instability is reviewed. Natural history, clinical evaluation and imaging are described.
RESULTS
An awareness of the disorder, together with a thoughtful evaluation, beginning with the clinical history, usually leads to proper diagnosis. An appropriate physical exam, taking in account hyperlaxity and specific tests for posterior instability should be done.
CONCLUSION
Posterior shoulder instability is an uncommon condition and is challenging to diagnose. There is not a single injury that is responsible for all cases of recurrent shoulder dislocation or subluxation, and the presence of soft tissue lesions or bone alterations should be evaluated, with the use of adequate simple radiology and multiplanar imaging.
背景
后向不稳定的发生率较低，仅占所有不稳定肩部的2%至10%。后向不稳定的肩部包括不同的表现形式，如固定性脱位、复发性半脱位或脱位。
方法
回顾了与后向不稳定相关的研究和在线内容。描述了其自然病史、临床评估和影像学表现。
结果
对该疾病的认识，以及从临床病史开始的深思熟虑的评估，通常会导致正确的诊断。应进行适当的体格检查，考虑到关节过度松弛以及针对后向不稳定的特定检查。
结论
后肩部不稳定是一种罕见的情况，诊断具有挑战性。并非单一损伤导致所有复发性肩关节脱位或半脱位病例，应使用适当的简单放射学和多平面成像评估软组织病变或骨质改变的存在情况。
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