Management of First-Time Shoulder Dislocation in the Contact Athlete
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- 作者：Michael A. Donohue ; MD* ; Alaina M. Brelin ; MD* ; Lance E. LeClere ; MD&dagger ; ; leclere.navy.sports@gmail.com
- 关键词：shoulder ; dislocation ; contact ; collision ; athlete ; management
- 刊名：Operative Techniques in Sports Medicine
- 出版年：2016
- 出版时间：December 2016
- 年：2016
- 卷：24
- 期：4
- 页码：236-241
- 全文大小：539 K
- 卷排序：24
文摘
First-time anterior shoulder dislocation in the contact and collision athlete represents a treatment challenge for the orthopaedic surgeon, especially if the athlete is in season. Treatment starts with immediate on-field management and transitions to a thorough history and physical examination off the field. Plain film and advanced imaging then help to guide the orthopaedic surgeon in the shared decision-making process. The decision to return an athlete to play in the same season carries a high risk of repeat dislocation or instability, and the surgeon must not only counsel the athlete on this but also protect the athlete from returning before safe to do so. The optimal surgical treatment—arthroscopic vs open vs bone block—remains controversial as well. Historically, open Bankart repair and stabilization has shown a decreased risk of recurrence compared with arthroscopic, but the current literature has support for either options. Additionally, some authors now advocate open osseous augmentation procedures as having the lowest recurrence rates. This article explores the decision-making process from first clinic contact through clinical management.