tailieunhanh - Sự bất ổn định Glenohumeral: Đánh giá và điều trị

Glenohumeral sự bất ổn bao gồm một quang phổ của các rối loạn về mức độ khác nhau, chỉ đạo, và nguyên nhân. Các phím được để chẩn đoán chính xác có lịch sử kỹ lưỡng và kiểm tra thể chất. Thường radiographers Plain là tiêu cực, đặc biệt là trong các hình thức tinh tế của sự bất ổn định. | Glenohumeral Instability Evaluation and Treatment Roger G. Pollock MD and Louis U. Bigliani MD Abstract Glenohumeral instability encompasses a spectrum of disorders of varying degree direction and etiology. The keys to accurate diagnosis are a thorough history and physical examination. Plain radiographs are frequently negative especially in subtle forms of instability. Computed tomography CT CT arthrography magnetic resonance imaging arthroscopy and examination under anesthesia may occasionally yield important diagnostic information. Nonoperative treatment of shoulder instability consists of reduction of the joint when necessary followed by immobilization and rehabilitative exercises. The length and the value of immobilization remain controversial. Rehabilitative programs emphasize strengthening of the dynamic stabilizers of the shoulder particularly the rotator cuff muscles. Both arthroscopic and open techniques can be used for operative stabilization of the glenohumeral joint. Results of these repairs are assessed not only in terms of recurrence rate but also in terms of functional criteria including return to athletics. Some standard repairs have declined in popularity giving way to procedures that directly address the pathology of detached or excessively lax capsular ligaments without distorting surrounding anatomy. Capsular repairs also allow correction of multiple components of instability. J Am Acad Orthop Surg 1993 1 24-32 Glenohumeral instability is a common shoulder disorder particularly in young athletically active individuals. Historically the orthopaedic literature has concentrated on the most common and dramatic form of instability the anterior dislocation. Numerous reports have described the pathologic lesions underlying recurrent instability and have proposed a variety of operative procedures to prevent recurrence. Over the past 10 to 20 years increased attention has been paid to recurrent subluxation and posterior and multidirectional instability.

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