前肩不稳的流行病学与自然史
The Epidemiology and Natural History of Anterior Shoulder Instability.
作者信息
Galvin Joseph W, Ernat Justin J, Waterman Brian R, Stadecker Monica J, Parada Stephen A
机构信息
Blanchfield Army Community Hospital, 650 Joel Dr, Fort Campbell, KY, 42223, USA.
Bowman Gray Center for Medical Education, Wake Forest University School of Medicine, 475 Vine Street, Winston-Salem, NC, 27101, USA.
出版信息
Curr Rev Musculoskelet Med. 2017 Dec;10(4):411-424. doi: 10.1007/s12178-017-9432-5.
Abstract
PURPOSE OF REVIEW
The purpose of this review is to outline the natural history and best clinical practices for nonoperative management of anterior shoulder instability.
RECENT FINDINGS
Recent studies continue to demonstrate a role for nonoperative treatment in the successful long-term management of anterior glenohumeral instability. The success of different positions of shoulder immobilization is reviewed as well. There are specific patients who may be best treated with nonoperative means after anterior glenohumeral instability. There are also patients who are not good nonoperative candidates based on a number of factors that are outlined in this review. There continues to be no definitive literature regarding the return to play of in-season athletes. Successful management requires a thorough understanding of the epidemiology, pathoanatomy, history, physical examination, diagnostic imaging modalities, and natural history of operative and nonoperative treatment.
摘要
综述目的
本综述旨在概述前肩不稳非手术治疗的自然病程及最佳临床实践。
最新发现
近期研究继续表明非手术治疗在前盂肱关节前向不稳的长期成功治疗中发挥作用。同时也对肩部固定于不同位置的治疗效果进行了综述。前盂肱关节前向不稳后，有特定患者可能采用非手术方法治疗效果最佳。基于本综述中概述的多种因素，也有患者不适合非手术治疗。目前仍没有关于赛季中运动员重返比赛的权威性文献。成功的治疗需要全面了解流行病学、病理解剖学、病史、体格检查、诊断性影像学检查方法以及手术和非手术治疗的自然病程。
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Ann Transl Med. 2016 Nov;4(21):419. doi: 10.21037/atm.2016.11.22.
3
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J Bone Joint Surg Am. 2016 Dec 7;98(23):1954-1961. doi: 10.2106/JBJS.15.01398.
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J Orthop. 2016 Oct 28;14(1):73-76. doi: 10.1016/j.jor.2016.10.017. eCollection 2017 Mar.
6
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