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复发性或俗称习惯性肩关节脱臼主要两类：类自肩关节弄脱位再弄位置患者表演〃自肩关节自由进；第二类见主要创伤经由外力造肩关节脱位遗症 第类习惯性肩关节脱臼患者没明显创伤病史且身处关节能度伸展及松弛现象譬说拇指轻易折并触及前臂；肘关节或膝关节度挺伸主要原先性身体组织较松弛造关节稳定且向性至於第二类其受伤造习惯性脱位明显创伤运伤害像投掷作太用力或投掷程忽遇阻力柔道、角力等身体接触技击运;摔倒手撑或肩膀著等意外作造肩关节脱位几乎都前向脱臼保守治疗(关节复位)再发脱位或半脱位情形 临床表徵 第肩关节受伤脱位经验非深刻原外剧痛觉肩膀脱并且随卡住弹数都需要再经由外力(西医或医)才能肩关节复位〃少部经由自或同伴协助拉〃总经番折腾脱落肩膀〃经数周休养肩膀恢复功能某患者运或工作做肩膀举、外转及外展作简单说类似投掷作肩关节掉卡住、剧痛其自弄〃复发性脱位;能觉卡〃声肩膀扭且突听使唤自其转复发性半脱位脱位再复发机率第发脱位纪密切关系据统计第创伤造肩关节脱臼发20岁轻则再复发脱位机率60%95%;发20至30岁则复发机率40%70%;发30岁至40岁则其复发机率10%至40%;发喜运轻则复发机率亦高达80%二二三…….复发性脱位始发限制许肩关节及作仅事许运及工作即便自再、再注意都经意发脱位或半脱位拉扯重物、穿脱衣服 睡觉翻身等脱位数愈发觉肩关节愈易脱位自愈自行复位术关节范围受更限制 病理 问题第受伤肩关节内维持稳定重要构造(肩盂唇韧带)关节脱位间盂边缘撕裂并且骨剥离虽关节复位受伤部位没愈合形永久性缺口维持肩关节稳定度90%肩关节脱位都由前脱所肩盂唇韧带剥离处亦位於肩盂前；再脱位都发肩举外展及外转作另外脱位数前关节囊亦撑〃变愈愈松弛使脱位愈易发脱位关节受伤造关节软骨磨损或剥离掉落甚至造盂唇韧带撕裂数病於肩关节进进〃稳定意认要加注意某些良姿势或避免某些其减少脱位发机；些认许久才脱影响；更认自愈愈自行复位否病情减轻近愈愈研究报告及我自经验显示间肩关节稳定累积脱位或半脱位都造关节软骨磨损机肩关节炎 治疗 於先性习惯性脱位治疗由於没明显病灶问题组织结构松弛所原则保守(非手术)复健治疗主训练肩关节周围肌肉加强肌力帮助稳定关节效约80%除非已才手术式缩紧关节囊膜减少关节范围维持稳定至於创伤性肩关节脱位治疗则两面说：中国性期第脱臼发往都使用保守关节复位术静观其变〃於轻及运患者高复发率(80%―95%)让我始思考更治疗式降低明明知道必发〃良预近由於关节镜手术发展微创伤口手术技术针轻运员运患者或特殊职业军、警察等其第肩关节脱臼适予修补剥离肩盂唇韧带减少复发机及所带困扰与复发再治疗复杂性关节镜手术结些高复发率患者复发机降至10%―20%另面保守复健治疗於创伤习惯性脱位效并功率20%些病灶手术式矫缝合撕离韧带并收紧松弛关节囊膜术肩吊带保护二至四周并始关节八周始肌力训练十二周恢复四至六月恢复运我统计10间手术功率达95%近我更始使用关节镜手术式治疗除前述中国性期第肩关节脱位患者更於某些习惯性脱位其病灶受伤并太严重患者进行修补关节镜手术处伤口(三洞)术较痛较容易复健关节易僵硬容易恢复范围及功能短期治疗效放式手术结差 建议 要轻忽习惯性肩关节脱位重要性诊断要先确定(病史询问、理检查及磁振造影)才决定治疗向非受伤引起习惯性脱臼复健式治疗由受伤造脱臼则已手术式治疗唯稳定关节转稳定关节才机享受拘束并减少关节炎发机
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