Moroder P, Danzinger V, Minkus M, Scheibel M
Abteilung für Schulter- und Ellenbogenchirurgie, Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland.
Orthopade. 2018 Feb;47(2):139-147. doi: 10.1007/s00132-017-3513-4.
Posterior glenohumeral instability (PGHI) is an often unrecognized or misdiagnosed type of shoulder instability due to its heterogenic clinical and radiological presentation.
The ABC classification for PGHI is based on the different pathomechanisms and recommended treatment standards and is therefore a guide to finding the correct diagnosis and therapy for affected patients. There are different types of PGHI: A (first time), B (dynamic), C (static). These groups are further classified based on pathomechanical principles: A1: subluxation, A2: dislocation; B1: functional, B2: structural; C1: constitutional, C2: acquired.
In patients with type 1 PGHI (A1, B1, C1) conservative treatment is recommended while in patients with type 2 PGHI (A2, B2, C2) surgical treatment can be considered based on structural defects, clinical symptoms, chronicity, age, functional demand, and patient-specific health status. In addition it has to be considered, that there is the possibility of coexisting or overlapping subtypes as well as the chance of progression from one category into another over time.
由于后盂肱关节不稳（PGHI）具有异质性的临床和影像学表现，它常常未被识别或误诊。
PGHI的ABC分类基于不同的发病机制和推荐的治疗标准，因此是为受影响患者找到正确诊断和治疗方法的指南。PGHI有不同类型：A（首次发作）、B（动态性）、C（静态性）。这些组根据病理力学原理进一步分类：A1：半脱位，A2：脱位；B1：功能性，B2：结构性；C1：先天性，C2：后天性。
对于1型PGHI（A1、B1、C1）患者，建议采用保守治疗，而对于2型PGHI（A2、B2、C2）患者，可根据结构缺陷、临床症状、慢性程度、年龄、功能需求和患者特定的健康状况考虑手术治疗。此外，必须考虑到可能存在共存或重叠的亚型，以及随着时间推移从一种类型进展为另一种类型的可能性。
