Consensus statement on shoulder instability.
Consensus statement on shoulder instability.
复制标题
关于肩部不稳定的共识声明。
DOI：
10.1016/j.arthro.2009.06.022
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
G. Poehling
中科院分区：
文献类型：
--
作者：
K. Bak;Ethan R. Wiesler;G. Poehling
肩关节不稳定的理解和治疗是骨科领域的一个快速发展的领域。评估方法在显示引起症状的确切病理方面变得更加具体。磁共振关节造影术和关节镜检查有助于这一发展。肩关节不稳定的患者应通过病史和肩关节及肩胛胸关节的具体临床检查进行全面评估。通常，肩关节不稳可以在初步评估后进行分类。磁共振关节造影和关节镜检查是软组织评估的金标准，而专门的放射学检查和计算机断层扫描用于评估骨缺损。根据术前或治疗前评估发现的病理学对患者进行治疗。在制定治疗方案之前，需要考虑多种因素，包括患者的年龄、活动需求、相关病理和功能障碍、软组织病理、不稳定程度、方向、频率和病因。治疗可以是非手术或关节镜或开放修复。软组织病理学和骨缺损应该得到解决，外科医生的首选方法和技能在为患者选择正确的治疗方法时非常重要。应告知患者可能的并发症、治疗期间的限制以及特定类型不稳定的预后。为了提高肩关节矫形术的进展，最重要的因素之一可能是对精心设计和验证的结果测量工具的普遍认同。
The understanding and treatment of shoulder instability comprise a rapidly evolving area of interest in orthopaedics. Evaluation methods are becoming more specific in showing the exact pathologies causing the symptoms. Magnetic resonance arthrography and arthroscopy have contributed to this development. The patient with an unstable shoulder should be thoroughly evaluated through their history and specific clinical tests of the shoulder as well as the scapulothoracic joint. Often, shoulder instability can be classified after this primary evaluation. Magnetic resonance arthrography and arthroscopy are the gold standards in soft-tissue evaluation, whereas specialized radiographic examinations and computed tomography scans are used to assess bony defects. Patients are treated according to the pathology found on preoperative or pretreatment evaluation. Multiple factors need to be considered before the treatment program is instituted, including the patient's age, activity demands, associated pathology and dysfunction, soft-tissue pathology, degree of instability, direction, frequency, and etiology. Treatment can be nonoperative or arthroscopic or open repair. Soft-tissue pathology and bony defects should be addressed, and the surgeon's preferred method and skills are important in choosing the right treatment for the patient. The patient should be informed about possible complications, restrictions during the treatment period, and the prognosis for the particular type of instability. To improve progress in shoulder orthopaedics, one of the most important factors can be a universal agreement on an outcome measurement tool that is well designed and validated.