Di Giacomo Giovanni, Piscitelli Luigi, Marcello Gianmarco
Orthopedics and Traumatology Unit, Concordia Hospital, 90 Sette Chiese Street, 00145 Rome, Italy.
Orthopedics and Traumatology Unit, Concordia Hospital, 90 Sette Chiese Street, 00145 Rome, Italy.
Clin Sports Med. 2024 Oct;43(4):635-648. doi: 10.1016/j.csm.2024.03.021. Epub 2024 May 3.
In young athletes, anterior shoulder instability is a prevalent condition. Because of high-energy traumas, contact athletes often suffer recurrent instability, bone loss and postoperative recurrences. Patients younger than 20 years, symptomatic for more than 6 months, with ≥ 2 dislocations, with off-track Hill-Sachs lesion, glenoid bone loss, ALPSA lesion, Instability Severity Index Score > 3, and Glenoid Track Instability Management Score > 3 are at higher risk of failure. In cases of multiple dislocations with critical or subcritical glenoid bone loss, notably in collision and contact athletes, the Latarjet procedure is widely recognized as the treatment of choice.
在年轻运动员中,肩关节前不稳定是一种常见病症。由于高能量创伤,从事接触性运动的运动员常出现复发性不稳定、骨质流失和术后复发。年龄小于20岁、症状持续超过6个月、脱位≥2次、存在非轨迹性希尔-萨克斯损伤、肩胛盂骨质流失、关节囊-韧带-骨膜袖套撕脱损伤(ALPSA损伤)、不稳定严重程度指数评分>3以及肩胛盂轨迹不稳定管理评分>3的患者失败风险更高。在存在严重或临界肩胛盂骨质流失的多次脱位病例中,尤其是在碰撞和接触性运动的运动员中,Latjet手术被广泛认为是首选治疗方法。