全球肩部不稳定管理的视角:决策与治疗
Global Perspectives on Management of Shoulder Instability: Decision Making and Treatment.
作者信息
Friedman Lisa G M, Lafosse Laurent, Garrigues Grant E
机构信息
Midwest Orthopaedics at Rush, Rush University Medical Center, 1611 West Harrison Street, Chicago, IL 60612, USA.
Clinique Générale, Alps Surgery Institute, 4 Chemin de la Tour la Reine, 74000 Annecy, France.
出版信息
Orthop Clin North Am. 2020 Apr;51(2):241-258. doi: 10.1016/j.ocl.2019.11.008. Epub 2020 Jan 31.
The glenohumeral joint is prone to instability. Patients with instability should have a physical examination. Imaging studies can provide additional information. Classification schemes that into account soft tissue pathology, neuromuscular control, bone loss, and activity level. An arthroscopic Bankart repair is the mainstay for unidirectional instability. Bone block procedures are indicated for patients with bone loss or a failed attempt at stabilization surgery. The arthroscopic Latarjet is a promising option for these patients. For patients with multidirectional instability, prolonged rehabilitation is indicated, followed by capsular plication or inferior capsular shift if instability is unresponsive to physical therapy.
肩肱关节容易出现不稳定。不稳定的患者应进行体格检查。影像学检查可提供更多信息。分类方案应考虑软组织病理、神经肌肉控制、骨质流失和活动水平。关节镜下Bankart修复术是单向不稳定的主要治疗方法。对于有骨质流失或稳定手术尝试失败的患者,应采用骨块手术。关节镜下Latarjet手术对这些患者来说是一个有前景的选择。对于多向不稳定的患者,需要进行长期康复治疗,如果物理治疗后仍有不稳定,则进行关节囊折叠或下关节囊移位手术。