肩关节稳定机制再平衡理论在肩关节不稳和运动功能障碍治疗中的临床应用  

Rebalancing theory of shoulder stability mechanism for the diseases related to the shoulder instability and dysfunction of motion

作　　者：靳宝雍 李焱 马林 周兵华 唐康来 JIN Baoyong;LI Yan;MA Lin;ZHOU Binghua;TANG Kanglai(Department of Sports Medicine Center,the First Affiliated Hospital of the Army Military Medical University,Chongqing,445000,P.R.China)

机构地区：[1]中国人民解放军陆军军医大学第一附属医院运动医学中心,重庆445000

出　　处：《中国修复重建外科杂志》2022年第3期380-385,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：重庆英才创新领军人才项目(CQYC20200303135);陆军军医大学第一附属医院军事临床技术创新能力项目。

摘　　要：目的介绍肩关节稳定机制的新理论——再平衡理论,以及该理论在临床中的应用。方法通过广泛查阅近年来肩关节不稳和功能障碍的临床研究文献,结合本课题组临床实践经验,总结肩关节静力和动力稳定机制的相互作用。结果通过回顾文献并总结临床经验,笔者提出了"肩关节稳定机制再平衡理论",即当肩关节稳定机制破坏后,肩关节稳定可以通过肩关节静力稳定机制和动力稳定机制的再平衡来实现。在肩关节动力稳定失去平衡时,可通过动力稳定机制不同组织之间再平衡和/或静力稳定机制组织加强,恢复肩关节动力性稳定;在肩关节静力稳定失去平衡时,通过肩关节静力稳定机制中软组织和骨结构的再平衡来恢复肩关节静力性稳定。结论肩关节稳定机制再平衡理论是用整体、运动的观点来认识肩关节不稳和运动功能障碍的发生、发展和治疗后的转归,可以有效指导临床上肩关节不稳或运动功能障碍等涉及肩关节稳定机制疾患的治疗。Objective To introduce a new theory of shoulder stability mechanism,rebalancing theory,and clinical application of this new theory for the shoulder instability and dysfunction of motion.Methods Through extensive review of the literature related to shoulder instability and dysfunction of the motion in recent years,combined with our clinical practice experience,the internal relation between passive stability mechanism and dynamic stability mechanism were summarized.Results Rebalancing theory of shoulder stability mechanism is addressed,namely,when the shoulder stability mechanism is destructive,the stability of the shoulder can be restored by the rebalance between dynamic stability mechanism and passive stability mechanism.When dynamic stability is out of balance,dynamic stability can be restored by rebalancing the different parts of dynamic stability mechanism or to strengthen the passive stability mechanism.When passive stability mechanism is out of balance,passive stability can be restored by rebalancing the soft tissue and bone of the shoulder.Conclusion Rebalancing theory of shoulder stability mechanism could make a understanding the occurrence,development,and prognosis of shoulder instability and dysfunction from a comprehensive and dynamic view and guide the treatment effectively.

关 键 词：肩关节不稳 再平衡理论 动力稳定 静力稳定 

分 类 号：R684[医药卫生—骨科学]