Dines D M, Levinson M
Division of Orthopedic Surgery, North Shore University Hospital, New York, New York, USA.
Clin Sports Med. 1995 Oct;14(4):797-816.
The conservative management of shoulder instability depends on a well-defined program that emphasizes early diminution in the patient's symptoms, appropriate immobilization, and a well-defined precise rehabilitation program that can be individually tailored to meet the patient's needs. Immobilization should be considered in younger patients less than 20 years of age for between 3 to 4 weeks in order to enhance capsulolabral complex healing. Older patients may be immobilized for a shorter period of time. Analgesic medication and local physical therapeutic modalities may be used to decrease the patient's symptomatic complaints. Once the immobilization period has ended, a precise and specific rehabilitation program tailored for the individual needs of the patient should be undertaken. The rehabilitation program should emphasize early and safe regaining of normal ROM, strengthening of the dynamic stabilizers of the shoulder, and strengthening of the scapular stabilizing muscles of the shoulder. Finally, rehabilitation programs that enhance the patient's neuromuscular control over the glenohumeral joint should be considered in the conservative management of the unstable shoulder.
肩关节不稳的保守治疗依赖于一个明确的方案，该方案强调早期减轻患者症状、适当制动，以及一个可根据患者需求进行个体化定制的明确且精确的康复计划。对于20岁以下的年轻患者，应考虑制动3至4周，以促进关节囊盂唇复合体愈合。老年患者的制动时间可较短。可使用止痛药物和局部物理治疗方法来减轻患者的症状主诉。一旦制动期结束，就应开展针对患者个体需求的精确且特定的康复计划。康复计划应强调早期且安全地恢复正常活动范围、加强肩部动态稳定肌，以及加强肩部肩胛稳定肌。最后，在不稳定肩关节的保守治疗中，应考虑采用能增强患者对盂肱关节神经肌肉控制的康复计划。
