Friedman R J, Blocker E R, Morrow D L
Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston 29425, USA.
J South Orthop Assoc. 1995 Fall;4(3):182-99.
Glenohumeral instability can be defined as pain associated with loss of shoulder function due to excessive translation of the humeral head on the glenoid fossa. It can be classified according to many factors, such as direction, degree, mechanism, and frequency. A thorough understanding of the anatomy and biomechanics of the shoulder joint as they relate to instability is helpful in understanding the pathophysiology of this condition. All components of the instability must be correctly diagnosed so that appropriate treatment can be selected. Clinical examination is most important in making the correct diagnosis, but plain radiographs, arthrography, computed tomography, magnetic resonance imaging, examination under anesthesia, and arthroscopy can be helpful in difficult and challenging cases. Conservative treatment with a rehabilitation program can be successful in a large percentage of cases and should be the initial approach for most patients. Operative treatment is based on the direction and type of instability and is recommended only after an adequate trial of conservative therapy has failed to improve recurrent instability.
肩关节不稳可定义为由于肱骨头在肩胛盂上过度平移导致与肩部功能丧失相关的疼痛。它可根据许多因素进行分类，如方向、程度、机制和频率。深入了解与不稳相关的肩关节解剖学和生物力学，有助于理解这种病症的病理生理学。必须正确诊断不稳的所有组成部分，以便选择适当的治疗方法。临床检查对做出正确诊断最为重要，但在疑难病例中，普通X线片、关节造影、计算机断层扫描、磁共振成像、麻醉下检查和关节镜检查可能会有所帮助。采用康复计划的保守治疗在很大比例的病例中可能会成功，并且应该是大多数患者的初始治疗方法。手术治疗基于不稳的方向和类型，仅在充分尝试保守治疗未能改善复发性不稳后才推荐使用。
