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Anatomie und Ätiologie von SLAP- und Bizeps-Pulley-Läsionen

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Zusammenfassung

Läsionen der LBS und des stabilisierenden Bizeps-Pulley-Systems sind im klinischen Alltag sehr häufig und im Zusammenhang mit der Entstehung des anterosuperioren Schulterschmerzes von großer Bedeutung. Die Diagnosestellung wird durch die Kenntnis der Anatomie und ihrer Normvarianten erheblich erleichtert. Zudem können Überlegungen zur möglichen Ätiopathogenese wertvolle Hinweise auf zusätzliche Verletzungen der umliegenden Strukturen, wie z. B. der Sehnen des M. subscapularis und des M. supraspinatus, aber auch der Strukturen des Rotatoren-intervalls geben. Dies gilt besonders für Verletzungen der Bizeps-Pulley-Schlinge, die nur in Ausnahmefällen isoliert auftreten. Die LBS selbst weist Verletzungen zumeist ganz proximal am Ursprung in Form sog. SLAP-Läsionen auf, deren Entstehung sowohl mikro- als auch makrotraumatisch sein kann. Darüber hinaus finden sich im intraartikulären Anteil regelhaft degenerative Veränderungen.

Abstract

Lesions of the long head of the biceps tendon (LHB) and the biceps reflection pulley (BRP) are frequently seen as source of anterosuperior shoulder pain in clinical routine. Thorough acknowledgement of the anatomy and it’s normal variants allows an accurate diagnosis. Moreover consideration of potential etiopathogenetic mechanisms can guide proper identification of concomitant injuries of the adjacent anatomic structures, e.g. the subscapularis and supraspinatus tendons and the rotator interval. This is particularly true for lesions of the BRP, which are usually not seen as isolated tears. The LHB itself is in most cases injured at the very origin as so called SLAP lesions that can occur either due to micro- or macrotrauma. The intraarticular portion of the LHB is frequently seen with degenerative changes.

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Einhaltung ethischer Richtlinien

Interessenkonflikt.

S. Braun, M.J. Feucht und A.B. Imhoff geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinikum rechts der Isar Abteilung Sportorthopädie, TU München, Ismaninger Str. 22, 81675, München, Deutschland

    Sepp Braun &  Andreas B. Imhoff MD

  2. Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Freiburg, Deutschland

    Matthias J. Feucht MD

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  1. Sepp Braun
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Correspondence to Sepp Braun.

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Braun, S., Feucht, M. & Imhoff, A. Anatomie und Ätiologie von SLAP- und Bizeps-Pulley-Läsionen. Obere Extremität 9, 2–8 (2014). https://doi.org/10.1007/s11678-013-0242-0

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