Navlet Miguel García, Asenjo-Gismero Cristina Victoria
Shoulder and Elbow Unit, Upper extremity department at ASEPEYO Hospital Coslada, Madrid, Spain.
Orthopedic Resident at ASEPEYO Hospital Coslada, Madrid, Spain.
Open Orthop J. 2017 Aug 31;11:861-874. doi: 10.2174/1874325001711010861. eCollection 2017.
Multidirectional instability (MDI) represents a great challenge to the orthopedic surgeon. When treating these patients we must be aware that instability refers to a symptomatic situation, thus multidirectional instability is defined as symptomatic involuntary instability in two or more directions, and should be clearly differentiated from asymptomatic hyperlaxity. It may be associated with hyperlaxity, either congenital or acquired following repetitive stress, but also may be present without hyperlaxity, which is rare.
We searched in the online data bases and reviewed the relevant published literature available.
Many differences can be seen in the current literature when identifying these patients, unclear definitions and criteria to be included in this patient group are common.
Understanding the complex shoulder biomechanics as well as being aware of the typical clinical features and the key examination signs, which we review in this article, is of paramount importance in order to identify and classify these patients, allowing the best treatment option to be offered to each patient.
多向性不稳定（MDI）对骨科医生来说是一个巨大的挑战。在治疗这些患者时，我们必须意识到不稳定是指一种有症状的情况，因此多向性不稳定被定义为在两个或更多方向上有症状的非自愿性不稳定，并且应与无症状的关节过度松弛明确区分开来。它可能与先天性或重复性应力后获得性的关节过度松弛有关，但也可能在没有关节过度松弛的情况下出现，这种情况较为罕见。
我们在在线数据库中进行了检索，并查阅了现有的相关发表文献。
在识别这些患者时，当前文献中可以看到许多差异，该患者群体的定义和纳入标准不明确是常见的。
了解复杂的肩部生物力学，以及意识到我们在本文中回顾的典型临床特征和关键检查体征，对于识别和分类这些患者至关重要，从而能够为每个患者提供最佳的治疗方案。
