Jildeh Toufic R, Ference Daisy A, Abbas Muhammad J, Jiang Eric X, Okoroha Kelechi R
Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI, 48202, USA.
Wayne State University School of Medicine, 540 E Canfield St, Detroit, MI, 48201, USA.
Curr Rev Musculoskelet Med. 2021 Jun;14(3):246-254. doi: 10.1007/s12178-021-09705-8. Epub 2021 Apr 6.
Scapulothoracic dyskinesis (SD) occurs when there is a noticeable disruption in typical position and motion of the scapula, which can result in debilitating pain. The purpose of this review is to describe the current knowledge regarding the diagnosis and management of scapulothoracic dyskinesis by providing an evidence-based overview of clinical exams and treatment modalities available for orthopedic surgeons and provide insight into which treatment modalities require further investigation.
SD is highly prevalent in athletes, particularly those participating in overhead activities (e.g., baseball, tennis, and swimming) and can coexist with several shoulder pathologies. A holistic approach in the diagnosis of SD has been supported in the literature; however, it is important to recognize that diagnosis is currently limited to the absence of a quantitative SD clinical assessment. The main goal of the treatment of SD is to regain proper scapular positioning and dynamics. The standard of care for the management of SD is conservative interventions aimed at optimizing scapular kinematics. Surgical intervention is only considered in the presence of concomitant pathology requiring surgery. Due to the complexity of coordinated movement of the shoulder girdle, recent literature has begun to move away from the use of traditional orthopedic tests, in favor of a more system-based approach for the diagnosis of SD. We present a concise review of clinical exams and treatment modalities available for orthopedic surgeons in the management of SD.
肩胛胸壁关节运动障碍(SD)是指肩胛骨的典型位置和运动出现明显紊乱,可导致使人衰弱的疼痛。本综述的目的是通过为骨科医生提供基于证据的临床检查和治疗方式概述,来描述目前关于肩胛胸壁关节运动障碍的诊断和管理的知识,并深入探讨哪些治疗方式需要进一步研究。
SD在运动员中高度普遍,尤其是那些从事过头运动的运动员(如棒球、网球和游泳运动员),并且可能与多种肩部疾病共存。文献支持对SD进行整体诊断;然而,必须认识到目前的诊断仅限于缺乏定量的SD临床评估。SD治疗的主要目标是恢复肩胛骨的正确位置和动态。SD管理的标准治疗方法是旨在优化肩胛运动学的保守干预措施。仅在存在需要手术的伴随疾病时才考虑手术干预。由于肩胛带协调运动的复杂性,最近的文献已开始摒弃传统的骨科检查方法,转而采用更基于系统的方法来诊断SD。我们简要综述了骨科医生在管理SD时可用的临床检查和治疗方式。