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肩后不稳定:系统评价。

Posterior shoulder instability: a systematic review.

机构信息

Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy.

The University of Melbourne, Melbourne Medical School, Melbourne VIC 3010, Australia.

出版信息

Br Med Bull. 2020 Jul 9;134(1):34-53. doi: 10.1093/bmb/ldaa009.

Abstract

INTRODUCTION

This review aims to provide information on outcomes of surgical procedures for soft tissue or bony glenoid and/or humeral abnormalities in case of posterior shoulder instability.

SOURCE OF DATA

A systematic review of the literature according to the PRISMA guidelines was performed. A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, Ovid and Google Scholar databases using various combinations of the keywords 'shoulder', 'posterior instability', 'dislocation', 'reversed bony bankart', 'reversed Hill Sachs', and 'capsulolabral' was performed.

AREAS OF AGREEMENT

A total of 847 shoulders in 810 patients were included. A redislocation event occurred in 33 (8.7%) of 411 shoulders with soft tissue abnormalities and in 12 (9.1%) of 132 shoulders with bony abnormalities of the glenoid, humeral head or both.

AREAS OF CONTROVERSY

The optimal treatment modalities for posterior shoulder dislocation remain to be defined.

GROWING POINTS

Operative stabilization for posterior shoulder instability should be lesion-specific and should correct all components of the posterior instability.

AREAS TIMELY FOR DEVELOPING RESEARCH

Future prospective studies should aim to establish the optimal treatment modalities for posterior shoulder instability.

摘要

简介

本综述旨在提供有关治疗肩关节后向不稳定时肩胛盂和/或肱骨头软组织结构或骨结构异常的手术治疗效果的信息。

资料来源

根据 PRISMA 指南,对文献进行了系统综述。通过使用各种关键词(如“肩”、“后向不稳定”、“脱位”、“反向Bankart 骨”、“反向Hill Sachs”和“关节囊盂唇复合体”),在 PubMed、Medline、CINAHL、Cochrane、Embase、Ovid 和 Google Scholar 数据库中进行了全面检索。

意见一致的领域

共纳入 810 例患者的 847 个肩部。在 411 个存在软组织异常的肩部和 132 个存在肩胛盂、肱骨头或两者均有骨异常的肩部中,有 33 个(8.7%)和 12 个(9.1%)发生再脱位事件。

争议领域

治疗肩关节后向脱位的最佳治疗方法仍有待确定。

发展潜力

治疗肩关节后向不稳定的手术固定应具有针对性,并应纠正所有的后向不稳定因素。

适时开展研究的领域

未来的前瞻性研究应旨在确定治疗肩关节后向不稳定的最佳治疗方法。

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