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Knöcherne Bankart-Läsion und Glenoiddefekte

Von Techniken der Refixierung bis zur knöchernen Augmentation

Bony Bankart lesions and glenoid defects

From refixation techniques to bony augmentation

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Zusammenfassung

Rezidivierenden Schulterinstabilitäten liegt häufig ein Randdefekt der anterioren Cavitas glenoidalis scapulae (Glenoid) zugrunde. Grund hierfür können rezidivierende Luxationen mit Erosion des Glenoids oder Frakturen des anterioren Glenoidrands sein. Behandlungskonzepte für diese Entitäten unterscheiden sich maßgeblich. Während in der akuten Fraktursituation konservativ oder operativ therapiert werden kann, sollte bei fehlendem Fragment, insbesondere bei einer Defektgröße über 15–25 % der Glenoidfläche, die Möglichkeit einer Augmentation zur Stabilisierung der Schulter bedacht werden. Ziel des vorliegenden Beitrags ist die Zusammenfassung von Diagnostik und Therapie der akuten Fraktursituation sowie der chronischen Instabilität bei anteriorem Glenoidranddefekt.

Abstract

Rim defects of the anterior glenoid cavity are a main reason for residual shoulder instability after traumatic dislocation of the shoulder. These defects can be the result of a glenoid rim fracture or chronic glenoid erosion after repeated shoulder dislocations. Treatment concepts for these entities are entirely different. While in the acute fracture situation glenoid rim fractures can be treated operatively or non-operatively, augmentation of the anterior glenoid for stabilization of the shoulder should be considered if the defect exceeds 15–25% of the anterior glenoid. The purpose of this article is to summarize the diagnostics and indications for treatment of glenoid rim fractures. Radiological assessment and options for augmentation are reviewed for both acute fractures as well as chronic instability following an anterior glenoid rim defect.

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  1. Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland

    V. Rausch,  M. Königshausen,  J. Geßmann,  T. A. Schildhauer &  D. Seybold

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Rausch, V., Königshausen, M., Geßmann, J. et al. Knöcherne Bankart-Läsion und Glenoiddefekte. Unfallchirurg 121, 117–125 (2018). https://doi.org/10.1007/s00113-017-0434-y

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