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Der Orthopäde

, Volume 47, Issue 2, pp 158–167 | Cite as

Aktuelle Aspekte und neue Techniken bei Schultereckgelenksprengung

  • J. Abel
  • M. A. Zumstein
  • L. Bolliger
  • M. O. Schär
Leitthema

Zusammenfassung

Die Verletzung des Akromioklavikulargelenks ist v. a. bei jungen und sportlichen Patienten eine häufige Verletzung des Schultergürtels und macht etwa 12 % der Schulterverletzungen aus. Die heute weitverbreitetste Einteilung ist die Klassifikation nach Rockwood, die 6 Typen abhängig vom Grad der Verletzung sowie von der vertikalen Dislokation unterscheidet. Da die horizontale Instabilität in dieser Klassifikation nicht entsprechend berücksichtigt wird, ist der Nutzen infrage gestellt. Während Typ-I- und Typ-II-Luxationen grundsätzlich konservativ und Typ-IV- bis Typ-VI-Luxationen operativ versorgt werden sollten, ist die Literatur bezüglich der Rockwood-Typ-III-Luxationen nicht konklusiv. Aus diesem Grund sind Einteilung sowie Therapie dieser Verletzungen vermehrt Gegenstand wissenschaftlicher Untersuchungen und Diskussionen, wobei aktuell noch kein Konsens besteht. Dieser Übersichtsbeitrag legt die heutige Evidenz für die Diagnostik, verschiedene Klassifikationen und die therapeutischen Möglichkeiten dar.

Schlüsselwörter

Akromioklavikulargelenk Rockwood-Klassifikation Luxation Instabilität Hakenplatte TightRope Bipod 

Abkürzungen

AC-DC

Acromion center to distal clavicle

AC

Akromioklavikular

ACJI

Acromioclavicular joint instability

BIPOD

Bipodale Fixationstechnik in vertikaler und horizontaler Richtung nach Akromioklavikulargelenksluxation

CC-Bänder

Korakoklavikuläre Bänder

CC-Distanz

Distanz zwischen Korakoid und Klavikula

CT

Computertomographie

GACA

Gleno-acromio-clavicular angle

GC-PC

Glenoid centre to posterior clavicle

ISAKOS

International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine

K-Draht

Kirschner-Draht

MRI

Magnetic resonance imaging

SLAP

Superior labrum anterior posterior

Current aspects and new techniques in dislocation of the shoulder joint

Abstract

With 12% of all injuries concerning the shoulder, acromioclavicular (AC) joint dislocations are a common injury especially in young and active patients. The Rockwood classification is widely accepted, which differentiates between six types depending on the degree of injury and the vertical dislocation. Because the classification does not adequately address the horizontal instability, its benefits are questionable and there is currently no consensus. For this reason, the classification and the therapy of these injuries are increasingly becoming the subject of scientific investigations. Whereas conservative treatment for type I and II injuries and operative treatment for type IV–VI injuries are widely accepted, there is still no agreement in treating type III lesions. The goal of this review article is to present the current evidence for the diagnostics, different classifications and therapeutic possibilities.

Keywords

Acromioclavicular joint Rockwood classification Dislocation Instability Hook plate TightRope Bipod 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

J. Abel, M.A. Zumstein, L. Bolliger und M.O. Schär geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben. Im Falle von nicht mündigen Patienten liegt die Einwilligung eines Erziehungsberechtigten oder des gesetzlich bestellten Betreuers vor.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • J. Abel
    • 1
  • M. A. Zumstein
    • 1
  • L. Bolliger
    • 1
  • M. O. Schär
    • 1
  1. 1.Universitätsklinik für Orthopädische Chirurgie und TraumatologieInselspital, Universität BernBernSchweiz

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