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Operationstechnik

  • Chapter
AE-Manual der Endoprothetik

Zusammenfassung

In der Literatur wird bei den Beiträgen zur Schulterendoprothetik die Technik des Zugangsweges häufi g nur beiläufi g erwähnt. Dies ist umso erstaunlicher, wenn man berücksichtigt, dass ein technisch korrekt ausgeführter Zugang zum Gelenk die entscheidende Voraussetzung zur vollständigen Darstellung des Humeruskopfes und des Glenoids sowie zur Beseitigung der meist vorhandenen Innenrotationskontraktur darstellt. Ohne einen vollständigen Überblick über die anatomischen Landmarken ist eine anatomische Kalottenresektion und achsgerechte Fräsung des Glenoids und somit eine anatomische Implantation einer modularen Prothese nicht möglich (Bauer et al. 1997; Habermeyer 2002). Ein Glenoidersatz kann ohne radikales humeralseitiges und glenoidalseitiges Kapsel- Release erheblich erschwert oder unmöglich sein. Die Technik des Zugangsweges zur Schulter erfordert aufgrund der unmittelbaren Nähe zum Gefäßnervenstrang exakte Grundkenntnisse der regionalen Anatomie (Gardner et al. 2005; McFarland et al. 2001). Nachfolgend sollen Indikation, Technik und Besonderheiten des deltopektoralen, superioren sowie des transakromialen Zuganges dargestellt werden.

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Authors and Affiliations

  1. ARCUS Sportklinik, Rastatter Strasse 17–19, 75179, Pforzheim, Deutschland

    Dr. med. Thomas Ambacher (Schulterchirurgie)

  2. Sektion Obere Extremität Schulter-, Ellenbogen- und Handchirurgie, Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Deutschland

    Prof. Dr. med. Markus Loew

  3. Orthopädische Klinik des Marienstifts Arnstadt, Wachsenburgallee 12, 99310, Arnstadt, Deutschland

    Prof. Dr. med. Ulrich Irlenbusch

  4. Orthopädische Klinik, König-Ludwig-Haus, Universität Würzburg, Brettreichstr. 11, 97074, Würzburg, Deutschland

    Dr. med. Olaf Rolf & Prof. Dr. med. Frank Gohlke

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  1. Dr. med. Thomas Ambacher
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  2. Prof. Dr. med. Markus Loew
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  3. Prof. Dr. med. Ulrich Irlenbusch
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  1. Sektion Obere Extremität Schulter-, Ellenbogen- und Handchirurgie, Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Deutschland

    Markus Loew

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Ambacher, T., Loew, M., Irlenbusch, U., Rolf, O., Gohlke, F. (2010). Operationstechnik. In: Loew, M. (eds) AE-Manual der Endoprothetik. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-02854-0_5

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