掷球运动员肩关节不稳定的当前处理理念。

IF 2.9 2区 医学 Q1 ORTHOPEDICS Current Reviews in Musculoskeletal Medicine Pub Date : 2024-09-01 Epub Date: 2024-06-25 DOI:10.1007/s12178-024-09910-1
Ryan R Thacher, Nathan H Varady, Tyler Khilnani, Christopher L Camp, Joshua S Dines
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引用次数: 0

摘要

回顾的目的:投掷运动员肩关节不稳定的处理仍然是一项挑战,因为肩关节的生理性松弛会促进成绩的提高,而肩关节的稳定性则是其内在需要,两者之间存在着微妙的平衡。本综述将讨论对疑似肩关节不稳定的投掷运动员的评估和管理,重点关注最新研究结果和发展:绝大多数肩关节不稳定的投掷运动员都经历过微妙的微小不稳定,这是重复性微小创伤的结果,而不是严重的不稳定。这些运动员可能会出现手臂疼痛、死臂或投掷速度下降等症状。最近的文献进一步证实,治疗这些运动员没有 "灵丹妙药",需要采取个性化、量身定制的治疗方法。虽然最初的非手术治疗仍是治疗的标志,但康复方案的效果参差不齐,一些患者最终将接受手术稳定治疗。在这些病例中,外科医生必须审慎考虑手术稳定的程度,因为盂肱关节有可能过度收紧,从而对运动员的表现产生不利影响。治疗投掷运动员的肩关节不稳定需要对其生理和生物力学基础有透彻的了解。手术稳定的效果并不一致,这导致人们将重点放在对这些运动员的非手术治疗上,并为非手术治疗效果不佳的病例保留手术。总之,我们需要对这种具有挑战性的病症进行更多高质量的研究。
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Current Concepts on the Management of Shoulder Instability in Throwing Athletes.

Purpose of review: The management of shoulder instability in throwing athletes remains a challenge given the delicate balance between physiologic shoulder laxity facilitating performance and the inherent need for shoulder stability. This review will discuss the evaluation and management of a throwing athlete with suspected instability with a focus on recent findings and developments.

Recent findings: The vast majority of throwing athletes with shoulder instability experience subtle microinstability as a result of repetitive microtrauma rather than episodes of gross instability. These athletes may present with arm pain, dead arms or reduced throwing velocity. Recent literature reinforces the fact that there is no "silver bullet" for the management of these athletes and an individualized, tailored approach to treatment is required. While initial nonoperative management remains the hallmark for treatment, the results of rehabilitation protocols are mixed, and some patients will ultimately undergo surgical stabilization. In these cases, it is imperative that the surgeon be judicious with the extent of surgical stabilization as overtightening of the glenohumeral joint is possible, which can adversely affect athlete performance. Managing shoulder instability in throwing athletes requires a thorough understanding of its physiologic and biomechanical underpinnings. Inconsistent results seen with surgical stabilization has led to a focus on nonoperative management for these athletes with surgery reserved for cases that fail to improve non-surgically. Overall, more high quality studies into the management of this challenging condition are warranted.

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来源期刊
CiteScore
7.50
自引率
2.40%
发文量
64
期刊介绍: This journal intends to review the most significant recent developments in the field of musculoskeletal medicine. By providing clear, insightful, balanced contributions by expert world-renowned authors, the journal aims to serve all those involved in the diagnosis, treatment, management, and prevention of musculoskeletal-related conditions. We accomplish this aim by appointing authorities to serve as Section Editors in key subject areas, such as rehabilitation of the knee and hip, sports medicine, trauma, pediatrics, health policy, customization in arthroplasty, and rheumatology. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 20 diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
期刊最新文献
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