Spagna Giovanni, Boehm Elisabeth, Lorenz Christina, Moroder Philipp, Scheibel Markus
Klinik für Schulter- und Ellbogenchirurgie, Schulthess Klinik Zürich, Lengghalde 2, 8008, Zürich, Schweiz.
Klinik für Traumatologie, Universitätsspital Zürich, Zürich, Schweiz.
Unfallchirurgie (Heidelb). 2023 Jul;126(7):569-580. doi: 10.1007/s00113-023-01340-x. Epub 2023 Jun 21.
Anterior glenohumeral instability is the most frequent type of shoulder instability. This is often associated with labral and osseous lesions leading to recurrent instability. A detailed medical history, a physical examination and targeted diagnostic imaging are necessary to assess possible pathological soft tissue alterations as well as bony lesions of the humeral head and the glenoid bone. Early surgical treatment has been shown to reduce the risk of recurrence, especially in young active athletes, and can avoid secondary damage. Shoulder dislocations in older patients also require a detailed assessment and selection of treatment as persisting pain and limitation of movement can occur due to rotator cuff lesions and nerve injuries. The purpose of this article is to provide an overview of the currently available evidence and results regarding diagnostic considerations and conservative vs. surgical treatment and time to return to sport after treatment of a primary anterior shoulder dislocation.
前盂肱关节不稳是最常见的肩部不稳类型。这通常与盂唇和骨性病变相关，可导致反复不稳。详细的病史、体格检查和针对性的诊断性影像学检查对于评估可能的病理性软组织改变以及肱骨头和肩胛盂骨的骨性病变是必要的。早期手术治疗已被证明可降低复发风险，尤其是在年轻的活跃运动员中，并且可以避免继发性损伤。老年患者的肩关节脱位也需要进行详细评估并选择治疗方法，因为肩袖损伤和神经损伤可能导致持续疼痛和活动受限。本文的目的是概述目前关于诊断考量、保守治疗与手术治疗以及初次前肩脱位治疗后恢复运动时间的现有证据和结果。
