Department of Trauma & Orthopaedic Surgery, Glasgow Royal Infirmary, Glasgow, UK.
Department of Trauma & Orthopaedic Surgery, Glasgow Royal Infirmary, Glasgow, UK.
J Shoulder Elbow Surg. 2018 Feb;27(2):189-195. doi: 10.1016/j.jse.2017.09.006. Epub 2017 Nov 10.
Glenohumeral dislocation is the most commonly encountered adult joint instability. The epidemiology in the United Kingdom and worldwide is unclear and often limited to young, active groups that are not representative of general populations. Information regarding epidemiology and outcome from a first dislocation is useful for trauma service planning and patient counseling. We calculated the incidence of shoulder instability after a first dislocation in our urban population and investigated predictors of recurrent instability.
A prospectively collected trauma database was retrospectively examined to identify patients with a first-time dislocation. Demographics, subsequent dislocation, and instability details were collected from electronic patient records.
In a 38-month study period, 329 first dislocations occurred in a population of 475,147 with mean follow-up 28.5 months (range, 10-50 months). The overall incidence for first-time dislocations in this population was 21.9 per 100,000 population, of which 7.9% sustained a redislocation and 6.1% had further symptomatic instability. There were 18.8% with associated greater tuberosity fractures, 8.8% sustained a nerve injury, and 2.7% were posterior dislocations. A bimodal distribution was observed for males (peak incidence per 100,000 of 42.1 and 50.9 in 15-24 and ≥85 age groups, respectively), and unimodal for females (peak 45.7 in the 65-74 age group).
We demonstrate a previously unreported burden of dislocation in older age groups and suggest a rate of recurrence lower than previously reported in the United Kingdom. The group aged 15 to 19 years was at the highest risk of recurrent dislocation and instability. Gender was not a significant predictor of instability.
盂肱关节脱位是最常见的成人关节不稳定。英国和全球的流行病学情况尚不清楚，且通常仅限于年轻、活跃的群体，这些群体并不能代表一般人群。了解首次脱位的流行病学和结果对于创伤服务规划和患者咨询很有用。我们计算了我们城市人群中首次脱位后肩不稳定的发生率，并调查了复发性不稳定的预测因素。
我们对一个前瞻性收集的创伤数据库进行了回顾性检查，以确定首次脱位的患者。从电子患者记录中收集人口统计学资料、随后的脱位和不稳定的详细信息。
在 38 个月的研究期间，在 475147 人的人群中发生了 329 例首次脱位，平均随访 28.5 个月（范围 10-50 个月）。该人群中首次脱位的总发生率为 21.9/100000，其中 7.9%发生再脱位，6.1%出现进一步的症状性不稳定。有 18.8%伴有大结节骨折，8.8%发生神经损伤，2.7%为后脱位。男性呈双峰分布（15-24 岁和≥85 岁年龄组的每 100000 人发病率峰值分别为 42.1 和 50.9），女性呈单峰分布（65-74 岁年龄组发病率峰值为 45.7）。
我们报告了以前未报道的老年人群中脱位的负担，并表明复发率低于英国以前的报告。15 至 19 岁年龄组再次脱位和不稳定的风险最高。性别不是不稳定的显著预测因素。
