Khanna Akshay, Fares Mohamad Y, Koa Jonathan, Boufadel Peter, Lopez Ryan D, Abboud Joseph A
Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, PA, USA.
Arch Bone Jt Surg. 2024;12(12):820-825. doi: 10.22038/ABJS.2024.81046.3697.
Posterior shoulder instability (PSI) is a shoulder pathology that is challenging to diagnose, leading to treatment delay and exacerbation of symptoms. Etiology can be both traumatic and atraumatic, and a comprehensive clinical history plays a significant role in achieving diagnosis. Imaging in the setting of PSI can reveal a reverse-Bankart lesion, a reverse Hill-Sachs lesion, posterior labral cysts, and potentially glenoid or lesser tuberosity fractures. Both conservative and surgical options exist for patients with PSI, and management often depends on case severity, extent of bone loss, and patient goals and expectations. Holistic patient education regarding the etiologies, mechanisms and possible treatment options available is pivotal for achieving high levels of patient satisfaction and optimal outcomes.
肩后不稳(PSI)是一种诊断具有挑战性的肩部疾病,会导致治疗延迟和症状加重。病因可能是创伤性的,也可能是非创伤性的,全面的临床病史对确诊起着重要作用。PSI情况下的影像学检查可发现反Bankart损伤、反Hill-Sachs损伤、后盂唇囊肿,以及可能的肩胛盂或小结节骨折。PSI患者有保守和手术两种治疗选择,治疗方案通常取决于病例的严重程度、骨质流失的程度以及患者的目标和期望。对患者进行关于病因、机制和可用治疗方案的全面教育,对于实现高水平的患者满意度和最佳治疗效果至关重要。