摘要
盂肱關節不穩定是肩關節常見但容易被忽略的疾病，但隨著運動與復健醫學的興盛，這個問題日漸受到重視。盂肱關節不穩定往往不是單一構造受損所造成，而且它發生的機制也會隨著它的形式、程度、方向的不同而改變。要正確的診斷盂肱關節不穩定，必須先清楚了解盂肱關節週遭的解剖構造、相關生物力學與盂肱關節不穩定之分類。藉著了解各個解剖構造對於穩定度的貢獻，如此在臨床的復健治療上會更有幫助。而提供盂肱關節穩定度的貢獻因子可區分為靜態穩定因子與動態穩定因子。靜態穩定因子包括骨骼形狀、關節唇、關節腔內負壓、關節囊及韌帶。而動態穩定因子包括肩旋轉肌群及肱二頭肌長頭、動態的韌帶張力與本體感覺，後兩者尚有爭議。盂肱關節不穩定的治療方式包括手術治療、非手術性復健治療、及術後復健治療。復健治療方式的決定必需考量病人年齡、傷害的嚴重度、不穩定的類型、不穩定之方向，靜態與動態穩定因子的狀況。期待隨著運動復健醫學的發展，未來對於本疾病的治療方式的選擇可以更加明確。
並列摘要
Glenohumeral instability is a common disease that usually been ignored in clinical subjects. With the improvement in sport medicine and rehabilitation, this problem and its underline mechanism drew a lot of attention recently. The possible mechanism for instability includes the difference of joint structure in type, degree, and direction of the glenohumeral joint. The understanding of anatomical and biomechanical proper ties in relating to the classification of glenohumeral instability is essential for clinical diagnosis. The result of rehabilitation will be improved significantly by revealing the contribution of stability in each anatomical structure. The contributing factors can be divided into two main categories: the static stabilizers and dynamic stabilizers. The static stabilizers include bony geometry, glenoid labrum, negative intra-articular pressure, shoulder capsule, and ligaments restraints. In dynamic stabilizers, the rotator cuff muscles, long head of biceps brachii, dynamic ligament tension and proprioception are usually been considered for glenohumeral instability. The surgery with post-surgical rehabilitation or nonsurgical therapy is the common treatment strategies for glenohumeral instability. In the rehabilitation of glenohumeral instability, several factors such as the age of patient, severity of instability, type and direction of instability, and the condition of both the static and dynamic stabilizers are necessary to be taken into consideration during design of therapeutical program. With the development of sport and rehabilitation medicine, the treatment of glenohumeral instability will be investigated for better outcome.
延伸閱讀
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