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.
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.
Abbreviations
- 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
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J. Abel, M.A. Zumstein, L. Bolliger und M.O. Schär geben an, dass kein Interessenkonflikt besteht.
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Abel, J., Zumstein, M.A., Bolliger, L. et al. Aktuelle Aspekte und neue Techniken bei Schultereckgelenksprengung. Orthopäde 47, 158–167 (2018). https://doi.org/10.1007/s00132-017-3517-0
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DOI: https://doi.org/10.1007/s00132-017-3517-0