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Klassifikationen und therapeutische Indikationen bei Skapulafrakturen

Classification and operative indications for fractures of the scapula

  • Leitthema
  • Published:
Trauma und Berufskrankheit

Zusammenfassung

Klassifikation von Skapulafrakturen

Frakturen der Skapula gehen aufgrund der anatomischen Nähe zum Brustkorb häufig mit thorakalen Begleitverletzungen einher. Dabei werden grundsätzlich intra- und extraartikuläre Skapulafrakturen unterschieden.

Therapie extraartikulärer Frakturen

Aus der Literatur ist ersichtlich, dass extraartikuläre Skapulafrakturen in der Regel gut unter konservativer Therapie ausheilen. Eine Ausnahme stellen Frakturen im Skapulahals dar, welche aufgrund des Muskelzugs des M. triceps brachii und der damit einhergehenden Verkippung bereits bei mäßiger Dislokation operiert werden sollten.

Therapie intraartikulärer Frakturen

Intraartikuläre Frakturen (Glenoidfrakturen) werden häufig schon bei minimaler Stufenbildung operiert, wobei hinsichtlich deren genauer Grenzen die Studienlage derzeit noch nicht ausreichend ist.

SSSC („superior shoulder suspensory complex“)

Ein gesondertes theoretisches Modell zur Stabilitätsbewertung stellt der SSSC dar, der einen Ring aus 3 Streben unter Beteiligung von knöchernen (Glenoid, Korakoid, Klavikula, Spina, Akromion) und ligamentären Strukturen (korakoklavikulare Bänder, akromioklavikulare Bänder) beschreibt, wobei die Dislokation von 2 der 3 Streben die Stabilität des Rings aufhebt und somit eine Operationsindikation darstellen sollte.

Abstract

Classification of scalpula fractures

Fractures of the scapula are often associated with concomitant injuries of adjacent anatomic structures (e.g., chest). Scapula fractures are basically subdivided into intra-articular and extra-articular fractures.

Treatment of extra-articular fractures

It could be shown within literature that extra-articular fractures usually heal uneventfully with nonoperative treatment. Exceptions are fractures of the scapular neck, which can displace secondarily because of the tension of the triceps muscle and should therefore be operated even in cases of moderate fracture displacement.

Treatment of intra-articular fractures

Intra-articular fractures (glenoid fractures) are frequently operated even in cases of small intra-articular step-offs. However, there are no exactly defined limits of nonoperative treatment within the current literature.

SSSC (superior shoulder suspensory complex)

A special theoretical model for definition of stability is the SSSC (superior shoulder suspensory complex), which describes a ring of three struts of bony (glenoid, coracoid, clavicula, spine, acromion) and ligament structures (coracoclavicular ligaments, acromioclavicular ligaments), whereby the displacement of two of the three struts compromises the stability of the ring and, thus, should be treated operatively.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Königshausen, D. Seybold, J. Gessmann und T.A. Schildhauer geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Chirurgische Universitäts- und Poliklinik, BG-Universitätsklinikum Bergmannsheil, Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland

    M. Königshausen, D. Seybold, J. Gessmann & T.A. Schildhauer

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  1. M. Königshausen
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  2. D. Seybold
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Correspondence to M. Königshausen.

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Königshausen, M., Seybold, D., Gessmann, J. et al. Klassifikationen und therapeutische Indikationen bei Skapulafrakturen . Trauma Berufskrankh 16, 6–12 (2014). https://doi.org/10.1007/s10039-014-2068-4

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