Sports Surgery Clinic, Northwood Avenue, Santry Demesne, Dublin 9, Ireland; Royal College of Surgeons in Ireland, Department of Trauma & Orthopaedic Surgery, 123 St. Stephens Green, Dublin 2, Ireland.
Sports Surgery Clinic, Northwood Avenue, Santry Demesne, Dublin 9, Ireland; Royal College of Surgeons in Ireland, Department of Trauma & Orthopaedic Surgery, 123 St. Stephens Green, Dublin 2, Ireland.
Surgeon. 2021 Oct;19(5):e88-e94. doi: 10.1016/j.surge.2020.08.005. Epub 2020 Sep 12.
Rugby has the highest incidence of traumatic injuries of any sport, and glenohumeral injuries result in the lengthy delay in return to play. The purpose of this study is to survey surgeons from the American Shoulder and Elbow Surgeons (ASES), and the British Elbow and Shoulder Society (BESS) to evaluate the current state of management of anterior glenohumeral instability, and compare the differences in practices.
A survey of surgeons from ASES and BESS was conducted. Treatment options were proposed in a variety of clinical scenarios of glenohumeral instability. The time of immobilization post-operatively, return to play, and attitudes on current contact regulations. Results were compared using the chi-square test or t-test.
Ninety-seven surgeons responded to the survey. There was a significant difference in treatment between ASES and BESS surgeons in the setting of primary dislocation (p < 0.05), but not recurrent dislocation (p > 0.05). The period of immobilization following injury and surgery was different between both treating groups. There was a significant difference in return to play between ASES and BESS surgeons with arthroscopic stabilization and open Bankart repair (p < 0.05), but not following conservative treatment or the Latarjet procedure (p > 0.05).
There remains wide variance on the management of glenohumeral instability in rugby union players among surgeons. While immobilization times post-operatively were similar, the BESS surgeons were more confident in allowing earlier return to play. There is also a significant concern that contact levels should be regulated to protect player safety.
Level 4 (case series).
橄榄球是所有运动中创伤性损伤发生率最高的运动，盂肱关节损伤导致其重返赛场的时间延长。本研究旨在调查美国肩肘外科医师学会（ASES）和英国肘肩外科医师学会（BESS）的外科医生，评估盂肱关节前向不稳定的当前管理状况，并比较实践中的差异。
对 ASES 和 BESS 的外科医生进行了调查。在盂肱关节不稳定的各种临床情况下提出了治疗选择。术后固定时间、重返赛场时间以及对当前接触规定的态度。使用卡方检验或 t 检验比较结果。
97 名外科医生对调查做出了回应。在初次脱位（p<0.05）的情况下，ASES 和 BESS 外科医生的治疗方法存在显著差异，但在复发性脱位（p>0.05）的情况下则没有。受伤和手术后的固定期在两组治疗组之间存在差异。在关节镜下稳定和开放式 Bankart 修复术（p<0.05）之间，ASES 和 BESS 外科医生的重返赛场时间存在显著差异，但在保守治疗或 Latarjet 手术（p>0.05）之间则没有。
在处理橄榄球联盟运动员盂肱关节不稳定方面，外科医生之间仍然存在很大的差异。尽管术后固定时间相似，但 BESS 外科医生更有信心允许更早地重返赛场。还有一个重要的关注点是，应该对接触水平进行监管，以保护运动员的安全。
4 级（病例系列）。
