Anterior Shoulder Dislocations in Sports
作者:
John G. Aronen,
期刊:
Sports Medicine
(Springer Available online 2012)
卷期:
Volume 3,
issue 3
页码: 224-234
ISSN:0112-1642
年代: 2012
DOI:10.2165/00007256-198603030-00006
出版商: Springer International Publishing
数据来源: Springer
摘要:
SummaryAnterior shoulder dislocations, primary and recurrent, are among the most disabling injuries to the shoulder that can plague the athlete. The diagnosis is easily made by the following: (a) the physical appearance of the shoulder; (b) loss of capability by the athlete to internally and externally rotate the shoulder with the elbow at his side; (c) by evaluating the mechanism of injury; and (d) x-rays. Anterior shoulder dislocations should be reduced as soon as possible after diagnosis, to minimise the stretching effect on the neurovascular structures while the humeral head is dislocated. The reduction isnotdone to allow the athlete to return immediately to sport. Use of a simple traction method in the first 10 to 15 minutes following the injury will result in a successful reduction in the vast majority of dislocations. Reduction of the humeral head can be confirmed by the athlete regaining the capability to internally and externally rotate his shoulder with his elbow at his side.Following reduction, the athlete should begin a treatment regimen which includes a restrengthening programme emphasising the muscles of internal rotation and adduction plus rigid restrictions of activities until the goals of the rehabilitation programme are satisfied. The author’s experience with this treatment regimen with athletes at the United States Naval Academy, has shown a decrease of the recurrence rate of primary anterior shoulder dislocations to 25% versus the 80% recurrence rate we have become familiar with from studies done which did not stress specific rehabilitation programmes. The athlete should also be instructed in a self-performed traction method for reduction should a re-dislocation occur, to minimise the stretching effect on the neurovascular structures and allow relief from discomfort.Surgery for primary and recurrent anterior dislocations should only be considered when the athlete fails to achieve the desired goals after participating in a specific, progressive, adequate rehabilitation programme.
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