Hastings D E, Coughlin L P
Am J Sports Med. 1981 Nov-Dec;9(6):352-5. doi: 10.1177/036354658100900602.
Recurrent subluxation of the shoulder is a common condition. In our hospital, 30% of operations for shoulder instability were performed on patients who never had a frank dislocation but presented with symptoms of instability or, occasionally, simply with pain on throwing. The most common physical finding in this group was apprehension on abduction-external rotation. Thirty-four of the 50 shoulders with subluxation showed radiological changes consisting mainly of infraglenoid new bone formation. Six showed fracture of the anterior glenoid margin. Examination under anaesthesia demonstrated the instability on all cases in which it was tested. Thirty-three of the 50 shoulders had Bankart lesions and six had anterior glenoid margin fractures. Thirty-nine shoulders were treated by Putti-Platt repair and 10 had stapling alone. There was a tendency for loss of external rotation in patients with Putti-Platt reinforcement. We conclude that recurrent subluxation of the shoulder is a common injury that can be confirmed by demonstrating subluxation under anaesthesia, and Bankart repair alone is recommended if the athlete is to return to throwing activities.
复发性肩关节半脱位是一种常见病症。在我院，30%的肩部不稳定手术是针对那些从未发生过明显脱位但有不稳定症状、或偶尔仅在投掷时疼痛的患者进行的。该组最常见的体格检查发现是外展 - 外旋时的恐惧征。50例半脱位的肩部中，34例显示出主要由盂下新骨形成组成的放射学改变。6例显示前盂缘骨折。麻醉下检查证实了所有接受检查病例的不稳定情况。50例肩部中33例有Bankart损伤，6例有前盂缘骨折。39例肩部采用Putti - Platt修复术治疗，10例仅行缝合术。接受Putti - Platt加固的患者有外旋丧失的倾向。我们得出结论，复发性肩关节半脱位是一种常见损伤，可通过麻醉下证实半脱位来确诊，并且如果运动员要恢复投掷活动，建议仅行Bankart修复术。
