Zusammenfassung
Die Ursachen einer klinischen Impingementsymptomatik können vielfältig sein, und vor einer undifferenzierten Anwendung der Akromioplastik kann nur gewarnt werden. Der Operateur sollte alle Erscheinungsformen funktioneller und sekundärer Impingementsyndrome kennen und mittels bildgebender, klinischer und schließlich arthroskopischer Diagnostik differenzieren. Nur die Kenntnis und Berücksichtigung der vielfältigen Schulterpathologien ermöglichen es, geeignete Patienten zur Akromioplastik zu finden oder andere Behandlungen durchzuführen.
Die subakromiale Dekompression ist heute in arthroskopischer Technik ein Routineverfahren, das der offenen Durchführung aufgrund der geringeren Traumatisierung eindeutig überlegen ist. Eine Voraussetzung ist die technische Fähigkeit des Operateurs, den Eingriff arthroskopisch adäquat durchzuführen, eine weitere, sehr wichtige Bedingung ist allerdings eine korrekte Indikationsstellung, d. h. das Vorliegen eines Outletimpingements.
Abstract
The causes of clinical impingement symptoms can be multifaceted and caution is warranted before performing undifferentiated acromioplasty. The surgeon should know all manifestations of functional and secondary impingement syndromes and distinguish them by imaging techniques, clinical diagnosis, and arthroscopy. Only the knowledge and consideration of the various shoulder pathologies make it possible to recognize patients suited for acromioplasty or to implement other treatment modalities.
Subacromial decompression as an arthroscopic technique has now become a routine procedure, which is far superior to an open approach because it is less traumatic. Prerequisite is an adequate technical ability of the surgeon to perform the arthroscopic intervention. Another, very important requirement is that the indication is indeed correct, i.e., presence of an outlet impingement has been verified.
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Ogon, P., Ogon, M. Das subakromiale Impingementsyndrom . Arthroskopie 16, 158–177 (2003). https://doi.org/10.1007/s00142-003-0229-8
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DOI: https://doi.org/10.1007/s00142-003-0229-8