[THE TREATMENT OF TRAUMATIC SHOULDER INSTABILITY - THE OPEN APPROACH VS. ARTHROSCOPIC APPROACH].

Harefuah Pub Date : 2022-09-01
Motti Zucker, Michael Drexler, Tal Kalimian, Yuval Glick, Moti Kramer, Yariv Goldstein
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Abstract

Introduction: Shoulder dislocation occurs when the head of the humerus disengages from the glenoid bone. About 95% of shoulder dislocations are traumatic, while the other 5% are not trauma-related in a patient with predisposing factors such as generalized ligamentous laxity. Ninety percent of shoulders dislocate anteriorly from direct force on the arm in the "ABER" position (Abduction- External Rotation). Usually, dislocations are accompanied by injuries to the shoulder that may lead to recurrent anterior shoulder instability and in the long-run, osteoarthritis of the shoulder joint. In the case of traumatic shoulder dislocation in the younger population or competitive sport players, accompanied with bone injury on X-ray's (Bony Bankart or Hill-Sachs), surgical treatment is recommended as soon as possible to avoid recurring dislocation and further joint damage. There are several options to treat recurrent shoulder instability, including soft tissue procedures, bone procedures, and a combination of these procedures. Surgery can be performed by an open or arthroscopic approach.

[外伤性肩关节不稳的治疗-开放入路与关节镜入路]。
肩关节脱位发生在肱骨头与肩关节骨脱离时。约95%的肩关节脱位是外伤性的,而其他5%的脱位与外伤性无关,但患者有广泛性韧带松弛等易感因素。在“ABER”姿势(外展-外旋)中,90%的肩部因手臂上的直接力而发生前脱位。通常,脱位伴随着肩部损伤,可能导致复发性肩关节前部不稳定和长期肩关节骨关节炎。对于年轻人群或竞技运动员的外伤性肩关节脱位,并伴有x光片上的骨损伤(bone Bankart或Hill-Sachs),建议尽快进行手术治疗,以避免再次脱位和进一步的关节损伤。治疗复发性肩部不稳定有几种选择,包括软组织手术、骨手术和这些手术的组合。手术可通过开放或关节镜入路进行。
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