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Aktuelle Behandlungskonzepte bei Muskelverletzungen

Current treatment concepts for muscular injuries

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Zusammenfassung

Muskelverletzungen stellen die häufigste Sportverletzung dar. Die 4 großen Muskelgruppen (Hamstrings, Adduktoren, Gastrocnemius und die Kniestrecker) stehen hier im Mittelpunkt der Behandlung. Meist handelt es sich um akute Verletzungen, die durch exzentrische Krafteinwirkungen entstehen. Die Diagnose beginnt mit einer genauen Anamneseerhebung des Traumas, gefolgt von einer exakten klinischen Untersuchung. Die Bildgebung mit Sonographie und Magnetresonanztomographie (MRT) stellt einen wichtigen Baustein in der Diagnostik dar, mit dem Ziel, die strukturelle Verletzung von der funktionellen Störung zu unterscheiden und das Ausmaß der Verletzung festzustellen. Die häufigste Therapieoption in der Behandlung der Muskelverletzung stellt die konservative Therapie dar und orientiert sich an den Phasen der Muskelheilung. In vielen Fällen (Freizeitsport) reicht eine konservative Therapie nach dem RICE-Prinzip mit nachfolgender beschwerdeabhängiger Aufbelastung aus, um die Rückkehr zum Sport zu gewährleisten. Die Infiltrationstherapie einschließlich Platet-rich-Plasma (PRP) kann eine Therapieoption darstellen, soll aber nicht zur Beschleunigung des Heilungsprozesses eingesetzt werden. Die operative Versorgung von Muskelverletzungen ist seltenen Indikationen vorbehalten.

Abstract

Muscular lesions represent the most common form of sports injury. The four large muscle groups hamstrings, adductors, gastrocnemius and knee extensor muscles are most often affected. Most injuries occur during excentric tension impact. Diagnostics begin with an exact medical history and detailed clinical investigations. Imaging with ultrasound and magnetic resonance imaging (MRI) are important to differentiate between structural lesions and functional disorders and to determine the extent of the injury. Most frequently treatment remains conservative and is oriented to the three phases of the healing process. In most cases (leisure sports) the rest, ice, compression and elevation (RICE) concept with subsequent pain-adapted load increase suffices for a return to sport activities. Infiltration therapy including platelet-rich plasma (PRP) is an additional therapy option but should not be used to accelerate the healing process. Surgical treatment only rarely becomes necessary for treatment of muscular injuries.

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  1. Sportklinik Stuttgart, Taubenheimstraße 8, 70372, Stuttgart, Deutschland

    F. Mauch M.A., R. Best & G. Bauer

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  1. F. Mauch M.A.
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  2. R. Best
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  3. G. Bauer
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Correspondence to F. Mauch M.A..

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Mauch, F., Best, R. & Bauer, G. Aktuelle Behandlungskonzepte bei Muskelverletzungen. Unfallchirurg 116, 488–496 (2013). https://doi.org/10.1007/s00113-013-2372-7

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