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上肢运动员肱二头肌和上盂唇复合体损伤的诊断与治疗

Diagnosis and Treatment of Injuries to the Biceps and Superior Labral Complex in Overhead Athletes.

作者信息

Calcei Jacob G, Boddapati Venkat, Altchek David W, Camp Christopher L, Dines Joshua S

机构信息

Hospital for Special Surgery, Department of Sports Medicine and Shoulder, 535 E 70th St, New York, NY, 10021, USA.

Mayo Clinic, Sports Medicine Center, Rochester, MN, 55902, USA.

出版信息

Curr Rev Musculoskelet Med. 2018 Mar;11(1):63-71. doi: 10.1007/s12178-018-9460-9.

Abstract

PURPOSE OF REVIEW

This review discusses the diagnostic and treatment challenges presented by injuries to the biceps and superior labral complex.

RECENT FINDINGS

A focused patient history, numerous physical examination maneuvers, and appropriate advanced imaging studies must be utilized to reach an accurate diagnosis. Nonoperative management, even in overhead athletes, has demonstrated relatively good outcomes, while operative outcomes have yielded mixed results. The surgeon must take into account a number of variables when choosing the appropriate surgical procedure: labral repair versus biceps tenodesis. Rehabilitation, either as nonoperative management or as a postoperative protocol, should focus on restoring glenohumeral and scapulothoracic strength, endurance, and full, pain-free range of motion, while correcting any deficiencies in balance or rhythm throughout the overhead motion. Despite the operative treatment challenges that SLAP tears present, with new techniques and proper patient selection, overhead athletes with injuries to the biceps and superior labrum complex can return to sport at a high level.

摘要

综述目的

本综述探讨肱二头肌和上盂唇复合体损伤所带来的诊断和治疗挑战。

最新发现

必须利用详尽的患者病史、多种体格检查手法以及适当的先进影像学检查来做出准确诊断。非手术治疗,即使是对于从事过头运动的运动员,也已显示出相对良好的效果,而手术治疗的结果则好坏参半。在选择合适的手术方式时,外科医生必须考虑多个变量:盂唇修复与肱二头肌固定术。康复治疗,无论是作为非手术治疗手段还是术后方案,都应着重恢复盂肱关节和肩胛胸壁的力量、耐力以及完全无痛的活动范围,同时纠正过头运动中平衡或节奏方面的任何缺陷。尽管SLAP损伤的手术治疗存在挑战,但通过新技术和恰当的患者选择,肱二头肌和上盂唇复合体损伤的过头运动运动员能够高水平地重返运动赛场。

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