From the Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, AZ.
J Am Acad Orthop Surg. 2024 Nov 1;32(21):965-974. doi: 10.5435/JAAOS-D-23-00863. Epub 2024 Jun 25.
Loss of shoulder function can be a complex condition to manage. Specifically, the definition between the terms pseudoparalysis and pseudoparesis remains inconsistent in the literature based on various factors including chronicity, present pathology, and the role of pain in the loss of function. There is also debate as to the optimal management strategies for these challenging conditions. In the setting of advanced glenohumeral arthritis or arthropathy in the correct patient, arthroplasty provides consistent and reliable results. However, in younger patients or the patient without arthritis, arthroplasty may not be the best option. In some cases, addressing pain with biceps procedures, balloon spacer placement, débridement, or others may be appropriate. However, other instances may require attempts at improving shoulder kinematics with procedures such as rotator cuff repair, superior capsular reconstruction, and tendon transfer. In this review, we discuss current definitions for pseudoparalysis and pseudoparesis, in addition to reviewing the indications for the various treatment options and their respective outcomes.
肩部功能丧失可能是一种难以处理的复杂情况。具体而言,基于慢性、现有病理和功能丧失中疼痛的作用等各种因素,术语“假性瘫痪”和“假性无力”之间的定义在文献中仍不一致。对于这些具有挑战性的情况,最佳的治疗策略也存在争议。在肱骨头关节炎或关节病晚期的正确患者中,关节置换术提供了一致且可靠的结果。然而,对于年轻患者或无关节炎患者,关节置换术可能不是最佳选择。在某些情况下,通过处理二头肌手术、球囊间隔物放置、清创术或其他方法来解决疼痛可能是合适的。但是,在其他情况下,可能需要通过旋转袖修复、肩袖上囊重建和肌腱转移等手术来改善肩部运动学。在这篇综述中,我们讨论了目前对假性瘫痪和假性无力的定义,此外还回顾了各种治疗选择的适应证及其各自的结果。