Lorente Alejandro, Mariscal Gonzalo, Barrios Carlos, Lorente Rafael
Department of Traumatology and Orthopaedic Surgery, University Hospital Ramón y Cajal, 28034 Madrid, Spain.
Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, 46001 Valencia, Spain.
J Clin Med. 2023 Jul 7;12(13):4546. doi: 10.3390/jcm12134546.
Glenohumeral dislocation is a common shoulder injury that can result in nerve injury. However, the full impact of these injuries on patient function and recovery remains unclear. This systematic review aimed to determine (1) the incidence, (2) risk factors, and (3) functional outcomes following nerve injuries after glenohumeral dislocation. The study followed PRISMA guidelines and used the PICO strategy. PubMed, EMBASE, Scopus, and Cochrane Collaboration Library databases were searched for studies. Two reviewers independently assessed the study eligibility, and data extraction was conducted by two authors. The quality of included studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Thirteen studies comprising 17,087 patients were included. The incidence of nerve injury ranged from 0.4% to 65.5%, with the axillary nerve being most commonly affected. The time to reduction did not significantly affect the incidence of nerve injury. The mechanism of injury, the affected side, associated injuries, and recovery time were found to be potential risk factors for nerve injury. Motor recovery was incomplete in many patients, and sensory recovery was less complete. By synthesizing the available evidence, this systematic review underscores the importance of considering nerve injury in the management of patients with glenohumeral dislocations. Future research can build on these findings to develop targeted prevention and treatment approaches that optimize patient outcomes.
肩肱关节脱位是一种常见的肩部损伤，可能导致神经损伤。然而，这些损伤对患者功能和恢复的全面影响仍不明确。本系统评价旨在确定（1）肩肱关节脱位后神经损伤的发生率、（2）危险因素和（3）功能结局。该研究遵循PRISMA指南并采用PICO策略。检索了PubMed、EMBASE、Scopus和Cochrane协作图书馆数据库中的研究。两名评审员独立评估研究的纳入资格，两名作者进行数据提取。使用非随机研究方法学指数（MINORS）标准评估纳入研究的质量。纳入了13项研究，共17087例患者。神经损伤的发生率在0.4%至65.5%之间，腋神经最常受累。复位时间对神经损伤的发生率没有显著影响。损伤机制、患侧、合并损伤和恢复时间被发现是神经损伤的潜在危险因素。许多患者的运动恢复不完全，感觉恢复更不完全。通过综合现有证据，本系统评价强调了在肩肱关节脱位患者管理中考虑神经损伤的重要性。未来的研究可以基于这些发现，制定有针对性的预防和治疗方法，以优化患者的预后。
