Obere Extremität

, Volume 6, Issue 1, pp 24–34 | Cite as

Arthroskopische Rekonstruktion der Subscapularissehne

Indikation, Technik, Ergebnisse
Leitthema
First Online:
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Zusammenfassung

Verletzungen der Subscapularissehne werden klinisch häufig übersehen. Relevante Rupturen haben allerdings eine erhebliche und nicht kompensierbare Dezentrierung und Funktionseinschränkung der Schulter zu Folge. Spezifische klinische Tests und moderne Schnittbildgebung führen zur Diagnose und präoperativen Klassifikation. Die Arthroskopie ermöglicht eine präzise Diagnostik und Klassifikation der Sehnenläsionen, wobei neben der intraartikulären Beurteilung bei höhergradigen Rupturen auch eine extraartikuläre Visualisierung der Subscapularissehne und der benachbarten Strukturen erforderlich ist. Die arthroskopische Rekonstruktion von Subscapularissehnenrupturen setzt nicht nur ein präzises anatomisches Verständnis und fortgeschrittene arthroskopische Fertigkeiten voraus, sondern sie erfordert neben der Technik der Refixation vor allem ein suffizientes Release der Sehnenstrukturen. Angaben zu Resultaten nach arthroskopischer Refixation sind in der Literatur noch spärlich vorhanden. Unter Beachtung der Klassifikation und der damit verbundenen Indikationsgrenzen lassen sich nach eigener Erfahrung gute Ergebnisse erzielen.

Schlüsselwörter

Sehnenverletzungen Ruptur Arthroskopie Schulter Orthopädische Verfahren 

Arthroscopic reconstruction of the subscapularis tendon

Indication, technique, outcome

Abstract

Lesions of the subscapularis tendon are often underdiagnosed in clinical practice. Relevant ruptures, however, lead to a decentering of the humeral head followed by pain and loss of function. Specific clinical tests and the modern methods of imaging allow for the correct diagnosis and preoperative classification. Arthroscopy permits the precise structural diagnosis of subscapularis tendon lesions. Retracted lesions require an intraarticular as well as extraarticular visualization of the tendon and the surrounding structures. The arthroscopic reconstruction of the subscapularis tendon requires not only are a profound understanding of shoulder anatomy and advanced technical skills, but the fixation technique with sufficient release of the tendon is also needed. There is still only little data in the literature on the outcome after arthroscopic reconstruction. However, using the appropriate technique and respecting the limits of indication, good results can be attained.

Keywords

Tendon injuries Rupture Arthroscopy Shoulder Orthopedic procedure 
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Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer 2011

Authors and Affiliations

  1. 1.Sportsclinic GermanyHannoverDeutschland
  2. 2.Alps Surgery InstituteClinique GeneraleAnnecyFrankreich
  3. 3.Klinik für OrthopädieUniversitätsklinikum Carl Gustav Carus, DresdenDresdenDeutschland

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