Načini liječenja dislokacije ramenog zgloba

master's thesis

• Title (english): Treatment methods of shoulder joint dislocation
• Author: Jeronim Romić
• Mentor: Nikica Daraboš (mentor)
• Committee member: Esmat Elabjer (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Nikica Daraboš (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Dislokacija ramenog zgloba najčešća je dislokacija u ljudskom tijelu. Jedan od razloga čestih dislokacija je nesrazmjer u kontaknim površinama zglobnih tijela. Traumatska prednja nestabilnost čini 95% glenohumeralnih nestabilnosti, a često se javlja u mlađih osoba i sportaša zbog čega je ova problematika izazov liječnicima. Nakon prvotne dislokacije pacijentima uglavnom slijede i opetovane dislokacije. Stoga je potrebno pristupiti pravodobnom i primjerenom liječenju. Posljedice ponovnih dislokacija su dodatna oštećenja struktura ramenog zgloba, poput Hill-Sachsove i Bankartove lezije koje, nastaju kod dislokacija. Nakon dislokacije je potrebna imobilizacija ramenog zgloba i mirovanje te potom rehabilitacija i razmatranje mogućnosti operacijskog liječenja. Kroz povijest su se razvile brojne tehnike operiranja nestabilnog ramena, otvorene i artroskopske tehnike, a u modernije vrijeme najbolje rezultate daju operacije rekonstrukcije kapsulolabralnog kompleksa, operacije ugradnje koštanog bloka te operacije ispune Hill-Sachsove lezije. Povijesno, otvorena Bankartova operacija smatrala se zlatnim standardom u liječenju ovog problema, no razvojem artroskopskih tehnika otvoreni načini operiranja gube na svojoj važnosti. Smjernice temeljene na dokazima u liječenju nestabilnog ramena za sada ne postoje, no njihovim razvojem pojednostavnio bi se odabir primjerenog načina liječenja dislokacije ramenog zgloba.

Abstract (english)

Shoulder joint dislocations are the most common dislocations in the human body. One of the main causes is a disproportion of articulation surfaces. Moreover, traumatic anterior instability accounts of 95% of glenohumeral dislocations, and it is the most frequent problem in younger population and athletes, thus making it a challenge for medical doctors. After the initial dislocation recurrent dislocations follow, therefore prompt and adequate treatment should be applied. Consequences of the recurrent dislocations can be additional lesions such as Hill-Sachs and Bankart lesions. After the dislocation, an immobilization and stillness of the shoulder joint are required, and the adequate rehabilitation program comes afterwards. Furthermore, surgical treatment should be highly considered. Throughout the history, there were many advances in different types of surgical techniques considering open and arthroscopic surgery, and recently the best results follow capsulolabral complex reconstructions, bone block and Hill-Sachs remplissage procedures. In the past, open Bankart operation was considered as the gold standard for surgical treatment of this problem, but with the development of arthroscopic techniques, open surgeries are losing their importance. Evidence based guidelines for shoulder dislocation treatments do not exist yet, but with their presence the choice for adequate treatment would be much easier.

• Keywords: dislokacija RZ; Hill-Sachsova lezija; otvorena Bankartova operacija; artroskopske operacije NRZ
• Keywords (english): Shoulder joint dislocation; Hill-Sachs lesion; Open Bankart repair; Arthroscopic shoulder instability procedures
• Language: croatian
• URN:NBN: urn:nbn:hr:105:512600
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-08-23 09:14:59