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肩部不稳定的技术要点。

Technical Pearls for Shoulder Instability.

出版信息

Instr Course Lect. 2021;70:23-36.

Abstract

Glenohumeral instability is one of the most common conditions of the upper extremity, especially in athletes and active individuals. Over the past two decades, there has been a transformation of surgical treatment from traditionally open repair/reconstruction to arthroscopic management. This has especially been true with management of both anterior and posterior instability without significant bone loss. In this setting, and in certain patient populations (eg, contact/collision athletes), arthroscopic treatment may not be sufficient. Therefore, open techniques, such as coracoid bone transfer, also occupy an important role in management of glenohumeral instability. The goal of this review is to provide technical "pearls" in management of glenohumeral instability. Specifically, the review will highlight treatments such as arthroscopic anterior and posterior instability repair, posterior glenoid bone augmentation, and open coracoid transfer (Latarjet) for anterior instability with bone loss. We will also review management of complications related to coracoid transfer.

摘要

肩盂肱不稳定是上肢最常见的病症之一,尤其在运动员和活跃人群中。在过去的二十年中,手术治疗已从传统的开放式修复/重建转变为关节镜管理。对于无明显骨丢失的前向和后向不稳定的管理尤其如此。在这种情况下,并且在某些患者群体中(例如接触/碰撞运动员),关节镜治疗可能并不足够。因此,开放性技术,如喙突骨转移,在肩盂肱不稳定的管理中也占有重要地位。本综述的目的是提供肩盂肱不稳定管理方面的技术“要点”。具体来说,该综述将重点介绍关节镜下前向和后向不稳定修复、后盂骨增强以及喙突转移(Latarjet)治疗有骨丢失的前向不稳定等治疗方法。我们还将回顾与喙突转移相关的并发症的管理。

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