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Wintersportverletzungen am Schultergelenk

Injuries of the shoulder in winter sports

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Zusammenfassung

Der Wintersport hat einen langen Weg hinter sich, von den ersten Skiwettkämpfen in Norwegen im Jahr 1767 bis zu den heute rund 200 Mio. Skifahrern weltweit. Da allein in Deutschland jährlich etwa 8000 Verletzungen zu verzeichnen sind, besteht ein erhöhter Bedarf an Bewusstsein für wintersportbedingte Verletzungen und deren Behandlung. Nach dem jüngsten Bericht der Auswertungsstelle für Skiunfälle (ASU) machen allein die Schulterverletzungen mehr als 20 % aller Verletzungen aus (Männer 26,1 % und Frauen 13 %; [39]). Die häufigsten den Schultergürtel betreffenden Verletzungen sind Verletzungen der Rotatorenmanschette, Schulterluxationen, Luxationen des Akromioklavikulargelenks (ACG) sowie Schlüsselbeinfrakturen [26, 31, 36]. Diese Verletzungen sind in erster Linie das Ergebnis von 4 Unfallmechanismen: direkter Aufprall, axiale Belastung des ausgestreckten Arms, erzwungene Abduktion des Arms gegen Widerstand und externe Rotationskräfte, die sich z. B. aus einem fest aufgesetzten Skistock beim Sturz ergeben können [33]. In diesem Artikel werden die 3 häufigsten Verletzungen des Schultergürtels im Wintersport beschrieben und die wichtigsten Fragen für den Sportler geklärt.

Abstract

Skiing as a sport has come a long way from the first competitive event in Norway in 1767 to about 200 million skiers today worldwide. With Germany alone recording around 8000 injuries annually, there is an increased need for awareness for winter-sport-related injuries and their management. According to the latest report by “Auswertungsstelle für Skiunfälle” (ASU, evaluation center for ski accidents), shoulder injuries alone account for more than 20% of injuries to all body regions (men 26.1% and women 13%). The most common injuries affecting the shoulder girdle are rotator cuff strains, glenohumeral dislocations, acromioclavicular dislocations and clavicle fractures. These injuries are primarily the result of four mechanisms: direct impact, axial load on an extended arm, resisted forced abduction of the arm, and external rotation forces resulting from a firmly planted ski pole in the grasp of a skier during a fall. In this article, we describe the three most common shoulder girdle injuries in winter sports along with their management and answer the most important questions for the athlete.

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Abbreviations

AC:

Akromioklavikular

ACG:

Akromioklavikulargelenk

ALPSA:

„Anterior labral periosteal sleeve avulsion“

ASU:

Auswertungsstelle für Skiunfälle

CC:

Korakoklavikular

FTAGD:

Erstmalige anteriore glenohumeralen Luxation

GLAD:

„Glenoid labral articular disruption“

HAGL:

„Humeral avulsion of glenohumeral ligament“

MRT:

Magnetresonanztomographie

PRP:

„Platelet rich plasma“

RCT:

Rotatorenmanschettenruptur

Literatur

  1. Abdul-Rassoul H, Galvin JW, Curry EJ et al (2019) Return to sport after surgical treatment for anterior shoulder instability: a systematic review. Am J Sports Med 47:1507–1515. https://doi.org/10.1177/0363546518780934

    Article  PubMed  Google Scholar 

  2. Aliprandi A, Messina C, Arrigoni P et al (2017) Reporting rotator cuff tears on magnetic resonance arthrography using the Snyder’s arthroscopic classification. WJR 9:126. https://doi.org/10.4329/wjr.v9.i3.126

    Article  PubMed  PubMed Central  Google Scholar 

  3. Balke M, Schneider M, Shafizadeh S et al (2013) Current state of treatment of acute acromioclavicular joint injuries in Germany: is there a difference between specialists and non-specialists? A survey of German trauma and orthopaedic departments. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-013-2795-2

    Article  PubMed  Google Scholar 

  4. Beitzel K, Cote MP, Apostolakos J et al (2013) Current concepts in the treatment of acromioclavicular joint dislocations. Arthroscopy 29:387–397. https://doi.org/10.1016/j.arthro.2012.11.023

    Article  PubMed  Google Scholar 

  5. Braun S, Imhoff AB, Martetschläger F (2015) Arthroskopisch gestützte Techniken zur Versorgung der akuten und chronischen AC-Gelenk-Verletzung. Unfallchirurg 118:407–414. https://doi.org/10.1007/s00113-015-0004-0

    Article  CAS  PubMed  Google Scholar 

  6. Buss DD, Lynch GP, Meyer CP et al (2004) Nonoperative management for in-season athletes with anterior shoulder instability. Am J Sports Med 32:1430–1433. https://doi.org/10.1177/0363546503262069

    Article  PubMed  Google Scholar 

  7. Carr AJ, Murphy R, Dakin SG et al (2015) Platelet-rich plasma injection with arthroscopic acromioplasty for chronic rotator cuff tendinopathy: a randomized controlled trial. Am J Sports Med 43:2891–2897. https://doi.org/10.1177/0363546515608485

    Article  PubMed  Google Scholar 

  8. Collin P, Matsumura N, Lädermann A et al (2014) Relationship between massive chronic rotator cuff tear pattern and loss of active shoulder range of motion. J Shoulder Elbow Surg 23:1195–1202. https://doi.org/10.1016/j.jse.2013.11.019

    Article  PubMed  Google Scholar 

  9. Davey MS, Hurley ET, Scanlon JP et al (2021) Excellent clinical outcomes and rates of return to play after arthroscopic rotator cuff repair for traumatic tears in athletes aged 30 years or less. Arthrosc Sports Med Rehabil 3:e667–e672. https://doi.org/10.1016/j.asmr.2021.01.003

    Article  PubMed  PubMed Central  Google Scholar 

  10. De Carli A, Lanzetti R, Ciompi A et al (2015) Acromioclavicular third degree dislocation: surgical treatment in acute cases. J Orthop Surg Res 10:13. https://doi.org/10.1186/s13018-014-0150-z

    Article  PubMed  PubMed Central  Google Scholar 

  11. Faggiani M, Vasario GP, Mattei L et al (2016) Comparing mini-open and arthroscopic acromioclavicular joint repair: functional results and return to sport. Musculoskelet Surg 100:187–191. https://doi.org/10.1007/s12306-016-0411-6

    Article  CAS  PubMed  Google Scholar 

  12. Flint JH, Wade AM, Giuliani J, Rue J‑P (2014) Defining the terms acute and chronic in orthopaedic sports injuries: a systematic review. Am J Sports Med 42:235–241. https://doi.org/10.1177/0363546513490656

    Article  PubMed  Google Scholar 

  13. Hann C, Kraus N, Minkus M et al (2018) Combined arthroscopically assisted coraco- and acromioclavicular stabilization of acute high-grade acromioclavicular joint separations. Knee Surg Sports Traumatol Arthrosc 26:212–220. https://doi.org/10.1007/s00167-017-4643-2

    Article  PubMed  Google Scholar 

  14. Hawkins RJ, Kennedy JC (1980) Impingement syndrome in athletes. Am J Sports Med 8:151–158. https://doi.org/10.1177/036354658000800302

    Article  CAS  PubMed  Google Scholar 

  15. Imhoff AB, Savoie FH III (2019) Rotator cuff across the life span: ISAKOS consensus book. Springer

    Book  Google Scholar 

  16. Itoi E (2013) Rotator cuff tear: physical examination and conservative treatment. J Orthop Sci 18:197–204. https://doi.org/10.1007/s00776-012-0345-2

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kay J, Memon M, Alolabi B (2018) Return to sport and clinical outcomes after surgical management of acromioclavicular joint dislocation: a systematic review. Arthroscopy 34:2910–2924.e1. https://doi.org/10.1016/j.arthro.2018.04.027

    Article  PubMed  Google Scholar 

  18. Kelley N, Pierpoint L, Spittler J, Khodaee M (2021) Acromioclavicular joint injuries at a Colorado ski resort. Phy Sportsmed. https://doi.org/10.1080/00913847.2021.1980745

    Article  Google Scholar 

  19. Kocher MS, Feagin JA (1996) Shoulder injuries during alpine skiing. Am J Sports Med 24:665–669. https://doi.org/10.1177/036354659602400517

    Article  CAS  PubMed  Google Scholar 

  20. Lacheta L, Rupp M‑C, Achtnich A et al (2021) Biceps Brachii alterations following the Latarjet procedure: a prospective multicenter study. JCM 10:5487. https://doi.org/10.3390/jcm10235487

    Article  PubMed  PubMed Central  Google Scholar 

  21. Marcheggiani Muccioli GM, Manning C, Wright P et al (2016) Acromioclavicular joint reconstruction with the LARS ligament in professional versus non-professional athletes. Knee Surg Sports Traumatol Arthrosc 24:1961–1967. https://doi.org/10.1007/s00167-014-3231-y

    Article  PubMed  Google Scholar 

  22. Martetschläger F, Imhoff AB (2014) Schulterluxation des Sportlers. Orthopäde 43:236–243

    Article  PubMed  Google Scholar 

  23. Martetschläger F, Tauber M, Habermeyer P, Hawi N (2016) Arthroscopically assisted acromioclavicular and coracoclavicular ligament reconstruction for chronic acromioclavicular joint instability. Arthrosc Tech 5:e1239–e1246. https://doi.org/10.1016/j.eats.2016.07.014

    Article  PubMed  PubMed Central  Google Scholar 

  24. Martetschläger F, Kraus N, Scheibel M et al (2019) The diagnosis and treatment of acute dislocation of the acromioclavicular joint. Dtsch Arztebl Int. https://doi.org/10.3238/arztebl.2019.0089

    Article  PubMed  PubMed Central  Google Scholar 

  25. Martetschläger F, Tauber M, Habermeyer P, Selim HA (2019) Arthroscopic coracoclavicular and acromioclavicular stabilization of acute acromioclavicular joint dislocation by suspensory fixation system. Arthrosc Tech 8:e611–e615. https://doi.org/10.1016/j.eats.2019.02.002

    Article  PubMed  PubMed Central  Google Scholar 

  26. McCall D, Safran MR (2009) Injuries about the shoulder in skiing and snowboarding. Br J Sports Med 43:987–992. https://doi.org/10.1136/bjsm.2009.068767

    Article  CAS  PubMed  Google Scholar 

  27. Millett PJ, Warth RJ, Dornan GJ et al (2014) Clinical and structural outcomes after arthroscopic single-row versus double-row rotator cuff repair: a systematic review and meta-analysis of level I randomized clinical trials. J Shoulder Elbow Surg 23:586–597. https://doi.org/10.1016/j.jse.2013.10.006

    Article  PubMed  Google Scholar 

  28. Mouhsine E, Garofalo R, Crevoisier X, Farron A (2003) Grade I and II acromioclavicular dislocations: results of conservative treatment. J Shoulder Elbow Surg 12:599–602. https://doi.org/10.1016/S1058-2746(03)00215-5

    Article  PubMed  Google Scholar 

  29. Murrell GA, Walton JR (2001) Diagnosis of rotator cuff tears. Lancet 357:769–770. https://doi.org/10.1016/S0140-6736(00)04161-1

    Article  CAS  PubMed  Google Scholar 

  30. Neer IICS (2005) Anterior acromioplasty for the chronic impingement syndrome in the shoulder. J Bone Joint Surg Am 87:1399. https://doi.org/10.2106/JBJS.8706.cl

    Article  PubMed  Google Scholar 

  31. Neurorehabilitation Clinic, Teaching Emergency Hospital “Bagdasar-Arseni”, Bucharest, Romania 2.“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Anghelescu A (2019) Short narrative review on main winter sports-related accidents: epidemiology, injury patterns, arguments for prophylactic behavior to avoid orthopedic and catastrophic neurological injuries. Balneo 10:45–49. https://doi.org/10.12680/balneo.2019.238

    Article  Google Scholar 

  32. O’Connor FG (2013) ACSM’s sports medicine: a comprehensive review. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  33. Owens BD, Nacca C, Harris AP, Feller RJ (2018) Comprehensive review of skiing and snowboarding injuries. J Am Acad Orthop Surg 26:e1–e10. https://doi.org/10.5435/JAAOS-D-16-00832

    Article  PubMed  Google Scholar 

  34. Pierpoint LA, Kerr ZY, Crume TL et al (2020) A comparison of recreational skiing- and snowboarding-related injuries at a Colorado ski resort, 2012/13-2016/17. Res Sports Med 28:413–425. https://doi.org/10.1080/15438627.2020.1754821

    Article  PubMed  Google Scholar 

  35. Porschke F, Schnetzke M, Aytac S et al (2017) Sports activity after anatomic acromioclavicular joint stabilisation with flip-button technique. Knee Surg Sports Traumatol Arthrosc 25:1995–2003. https://doi.org/10.1007/s00167-016-4287-7

    Article  PubMed  Google Scholar 

  36. Raiman L, Antbring R, Pyne D (2020) Winter sports injuries of the upper limb. InnovAiT 13:7–12. https://doi.org/10.1177/1755738019883310

    Article  Google Scholar 

  37. Ranebo MC, Björnsson Hallgren HC, Holmgren T, Adolfsson LE (2020) Surgery and physiotherapy were both successful in the treatment of small, acute, traumatic rotator cuff tears: a prospective randomized trial. J Shoulder Elbow Surg 29:459–470. https://doi.org/10.1016/j.jse.2019.10.013

    Article  PubMed  Google Scholar 

  38. Rosso C, Martetschläger F, Saccomanno MF et al (2021) High degree of consensus achieved regarding diagnosis and treatment of acromioclavicular joint instability among ESA-ESSKA members. Knee Surg Sports Traumatol Arthrosc 29:2325–2332. https://doi.org/10.1007/s00167-020-06286-w

    Article  PubMed  Google Scholar 

  39. Schulz D (2019/20) Unfälle und Verletzungen im alpinen Skisport, S 11

  40. Shaw MBK, McInerney JJ, Dias JJ, Evans PA (2003) Acromioclavicular joint sprains: the post-injury recovery interval. Injury 34:438–442. https://doi.org/10.1016/S0020-1383(02)00187-0

    Article  PubMed  Google Scholar 

  41. Song T, Yan X, Ye T (2016) Comparison of the outcome of early and delayed surgical treatment of complete acromioclavicular joint dislocation. Knee Surg Sports Traumatol Arthrosc 24:1943–1950. https://doi.org/10.1007/s00167-014-3225-9

    Article  PubMed  Google Scholar 

  42. Sood EM, Mlynarek RA, Bedi A (2021) The latarjet procedure for anterior shoulder instability. Oper Tech Orthop 31:100858. https://doi.org/10.1016/j.oto.2021.100858

    Article  Google Scholar 

  43. Tauber M (2013) Management of acute acromioclavicular joint dislocations: current concepts. Arch Orthop Trauma Surg 133:985–995. https://doi.org/10.1007/s00402-013-1748-z

    Article  PubMed  Google Scholar 

  44. Tauber M, Hradecky K, Martetschläger F (2020) Verletzungen des Akromioklavikulargelenks: Neues zur Biomechanik, Klassifikation, Diagnostik und Indikationsstellung. Obere Extrem 15:71–76. https://doi.org/10.1007/s11678-020-00560-6

    Article  Google Scholar 

  45. Tokish JM, Kuhn JE, Ayers GD et al (2020) Decision making in treatment after a first-time anterior glenohumeral dislocation: a Delphi approach by the Neer circle of the American shoulder and elbow surgeons. J Shoulder Elbow Surg 29:2429–2445. https://doi.org/10.1016/j.jse.2020.08.011

    Article  PubMed  Google Scholar 

  46. Warner JP, Krushell RJ, Masquelet A, Gerber C (1992) Anatomy and relationships of the suprascapular nerve: anatomical constraints to mobilization of the supraspinatus and infraspinatus muscles in the management of massive rotator-cuff tears. J Bone Joint Surg Am 74:36–45

    Article  CAS  PubMed  Google Scholar 

  47. Yagnik G, Seiler J, Vargas L et al (2021) Return to play after arthroscopic management of rotator cuff tears in professional contact athletes (245). Orthop J Sports Med 9:2325967121S0035. https://doi.org/10.1177/2325967121S00353

    Article  Google Scholar 

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  1. Deutsches Schulterzentrum in der ATOS Klinik München, Effnerstraße 38, 81925, München, Deutschland

    N. Wahal, A. Alabbasi &  F. Martetschläger

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  1. N. Wahal
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Correspondence to F. Martetschläger.

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N. Wahal, A. Alabbasi und F. Martetschläger geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Wahal, N., Alabbasi, A. & Martetschläger, F. Wintersportverletzungen am Schultergelenk. Orthopädie 51, 896–902 (2022). https://doi.org/10.1007/s00132-022-04322-w

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