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Verletzungen des Schultereckgelenks bei Sportlern

Injuries of the acromioclavicular joint in athletes

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Zusammenfassung

Sprengungen des Schultereckgelenks (Akromioklavikulargelenk, ACG) sind häufige Verletzungen des Schultergürtels, insbesondere bei Kontakt- und Hochrasanzsportlern. Neben der Verletzungsschwere sind beim Sportler und insbesondere beim Leistungs- und Hochleistungssportler bei der Wahl der Therapie auch die jeweilige Sportart, individuelle Karrierevorstellungen sowie der Zeitpunkt der Verletzung innerhalb des Jahreszyklus bzw. in Relation zur Wettkampfsaison zu berücksichtigen. Die konservative Therapie ist den niedriggradigen ACG-Instabilitäten und den „In-season“-Athleten vorbehalten. Sie hat die schnelle Schmerzfreiheit und die sichere Rückkehr zur Sportfähigkeit zum Ziel. Hochgradige Schultereckgelenkinstabilitäten sollten auch beim Sportler einer operativen Versorgung zugeführt werden. Arthroskopische bzw. arthroskopisch-assistierte Techniken bieten neben der Vermeidung potenzieller Nachteile der offenen Verfahren, wie Zweiteingriffe mit sekundärer Implantatentfernung und einer ausgiebigen Weichteilpräparation mit relevanter Zugangsmorbidität, ein geringeres Infektionsrisiko, unter kosmetischen Gesichtspunkten eine höhere Patientenakzeptanz und die Möglichkeit der Versorgung glenohumeraler Begleitläsionen.

Abstract

Acromioclavicular joint (ACJ) dislocation is a common injury to the shoulder girdle, especially in contact and high velocity sports. Besides the severity of the injury, and particularly in competitive and elite athletes and the type of sports, individual career plans and in and out of season injuries have to be taken into account when advising treatment for athletes. Conservative treatment is reserved for low-grade dislocations and in-season athletes. The aim is fast pain relief and a safe return to competitive sport. High-grade ACJ dislocations in athletes should be treated surgically. Arthroscopic and arthroscopically-assisted techniques can offer a lower risk of infection, a higher patient acceptance in terms of cosmetic perspectives and the potential to treat concomitant glenohumeral lesions and may avoid potential disadvantages of open techniques, such as secondary obligatory implant removal and extensive soft tissue preparation with a relevant approach morbidity.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. N. Kraus: keine Angaben. M. Scheibel ist Berater der Firma Arthrex und der Firma Karl Storz. Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethikkommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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  1. Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Campus Mitte und Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland

    N. Kraus &  M. Scheibel

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  1. N. Kraus
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  2. M. Scheibel
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Correspondence to M. Scheibel.

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Kraus, N., Scheibel, M. Verletzungen des Schultereckgelenks bei Sportlern. Chirurg 85, 854–863 (2014). https://doi.org/10.1007/s00104-014-2770-6

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