上部乳头和双肩复合体的原理:来自NEER Circle的专家共识
Nikhil N Verma1, Heinz Hoenecke2, Peter MacDonald3
1Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
Journal of shoulder and elbow surgery
|December 2, 2024
概括
专家一致认为,对上部乳头和双肩复合体 (SBC) 病理管理,年龄是关键因素. 年轻,活跃的患者从SLAP修复中受益,而年长,不那么活跃的个人可能更喜欢双肩治疗.
科学领域:
- 整形外科手术 整形外科手术
- 运动医学运动医学
- 肩部病理学 肩部病理学
背景情况:
- 上部乳头和双肩复合体 (SBC) 病理是肩部疼痛的常见原因.
- 有关前后 (SLAP) 上部乳房裂的最佳手术管理存在重大分歧.
研究的目的:
- 建立专家的共识,对管理上部乳头和双肩复合体 (SBC) 病理.
- 为SLAP撕裂和相关的双肩问题提供手术决策指导.
主要方法:
- 对92名来自NEER Circle的肩膀专家进行了一系列调查.
- 调查涵盖了专家的经验,诊断,治疗偏好,以及对48种手术方案 (脱bridement,SLAP修复,双肩治疗,联合治疗) 的共识.
- 达成共识需要在78个临床场景中对治疗方式达成80%的协议,包括对关节镜片的分析.
主要成果:
- 响应率从52.2%到58.7%不等,在78种场景中,26种场景达到了共识.
- 对于年轻,活跃的患有双肩或机械症状不稳定的患者来说,SLAP修复更受青.
- 双脚治疗是年长的,久坐不动的双脚肌病患者的首选;SLAP修复在老年患者与旋转手腕撕裂或之前的未能修复的病例中是禁忌的.
结论:
- 最佳的SBC病理管理取决于患者的年龄,职业和功能需求,年龄是主要因素.
- 较年轻,活跃的患者通常受益于SLAP修复,而要求较低的30岁以上患者可能更喜欢双肩治疗.
- 竞争力运动员的管理,特别是头顶投手,仍然存在争议,尽管SLAP修复在年轻投手中受到青.
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