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肩关节不稳定手术的并发症。

Complications of shoulder instability surgery.

作者信息

Wall M S, Warren R F

机构信息

Hospital for Special Surgery, New York, New York, USA.

出版信息

Clin Sports Med. 1995 Oct;14(4):973-1000.

PMID:8582009
Abstract

Complications of shoulder instability surgery may results from errors made during the preoperative, intraoperative, or postoperative periods. Some complications are preventable whereas the risk of others can be reduced. A few complications remain unpreventable. Two sources of error in the preoperative period that can lead to complications are an incorrect diagnosis and failure to address a patient's expectations of treatment. These errors and their subsequent complications are preventable. Preventing complications during the intraoperative period begins with proper patient positioning and a thorough knowledge of shoulder anatomy. Understanding the indications and limitations of the various stabilization procedures, as well as applying proper surgical technique, is essential to avoid a surgical misadventure. Complications recognized in the postoperative period include recurrent instability, limitation of motion, inability to return to the previous level of sport, problems related to hardware, pain, development of osteoarthritis, and neurovascular injuries. Infection and hematoma formation may also occur; both need to be recognized and treated early to maximize outcome. A protocol for treating each complication that may occur often is helpful. Knowledge of the complications that can arise is paramount to preventing their occurrence. This knowledge comes through experience, study, and continued research.

摘要

肩关节不稳手术的并发症可能源于术前、术中和术后阶段所犯的错误。一些并发症是可以预防的,而其他一些并发症的风险则可以降低。少数并发症仍然无法预防。术前可能导致并发症的两个错误来源是诊断错误和未能满足患者对治疗的期望。这些错误及其后续并发症是可以预防的。术中预防并发症始于正确的患者体位摆放和对肩部解剖结构的全面了解。了解各种稳定手术的适应症和局限性,并应用正确的手术技术,对于避免手术失误至关重要。术后发现的并发症包括复发性不稳、活动受限、无法恢复到以前的运动水平、与内固定物相关的问题、疼痛、骨关节炎的发展以及神经血管损伤。感染和血肿形成也可能发生;两者都需要早期识别和治疗以实现最佳结果。针对每种可能经常发生的并发症制定治疗方案会有所帮助。了解可能出现的并发症对于预防其发生至关重要。这种知识来自经验、研究和持续的探索。

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