Mandalapu Aniruddh, Hartwell Matthew, Veerkamp Matthew, Edmonds Eric, Milewski Matthew, Parikh Shital, Saluan Paul, Cordasco Frank, Pandya Nirav
University of Rochester School of Medicine, 601 Elmwood Ave, Rochester, NY, 14642, USA.
Department of Orthopedics, University of California, San Francisco, CA, USA.
Curr Rev Musculoskelet Med. 2025 Mar;18(3):87-93. doi: 10.1007/s12178-024-09941-8. Epub 2025 Feb 13.
Anterior shoulder instability management within skeletally immature patients presents a unique challenge for providers. This systematic review examines the surgical management of traumatic anterior shoulder instability in skeletally immature patients, focusing on recurrence rate, pre-operative conditions, post-operative conditions, demographics, and risk factors for failure. Four full-length articles met the inclusion and exclusion criteria, consisting of two retrospective cohort studies and two case series. In total, 77 patients and 79 shoulders underwent surgical stabilization. Mean age at time of surgery ranged from 12 to 15.9 years with a male proportion ranging from 58 to 86%. The indication for surgery in these studies was recurrent anterior shoulder instability. The most used surgeries for stabilization were bone block procedures, such as the Latarjet, followed by the arthroscopic Bankart repair. This review found that surgically managed traumatic anterior shoulder instability in skeletally immature patients had low recurrence rates. The studies examined had recurrence rates of 8%, 4.4% and 0% after surgical stabilization and a singular study showed a return to sport rate of 75%. Subsequently, this study suggests that open bony procedures may be a safe and effective solution to recurrent anterior shoulder instability in the skeletally immature population, but further research is needed to determine the optimal surgical approach with a larger sample of different surgical approaches.
Level IV.
对于骨骼未成熟患者的前肩不稳治疗，医疗人员面临着独特的挑战。本系统综述探讨骨骼未成熟患者创伤性前肩不稳的手术治疗，重点关注复发率、术前情况、术后情况、人口统计学特征以及失败的危险因素。有四篇全文文章符合纳入和排除标准，包括两项回顾性队列研究和两项病例系列研究。总共77例患者和79个肩部接受了手术稳定治疗。手术时的平均年龄在12至15.9岁之间，男性比例在58%至86%之间。这些研究中手术的指征是复发性前肩不稳。最常用的稳定手术是骨块手术，如Latarjet手术，其次是关节镜下Bankart修复术。本综述发现，骨骼未成熟患者手术治疗创伤性前肩不稳的复发率较低。所审查的研究在手术稳定后复发率分别为8%、4.4%和0%，一项单独的研究显示恢复运动率为75%。随后，本研究表明，开放性骨手术可能是骨骼未成熟人群复发性前肩不稳的一种安全有效的解决方案，但需要进一步研究以确定不同手术方法的更大样本的最佳手术方法。
四级。
