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Arthroskopisch relevante Anatomie der Schulterinstabilität

Arthroscopically relevant anatomy of shoulder instability

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Für die Diagnostik und adäquate Therapie von Schultererkrankungen ist eine detaillierte Kenntnis der anatomischen Strukturen und deren funktionelle Bedeutung erforderlich. Die Stabilität der Schulter wird durch das Zusammenspiel zwischen statischen und dynamischen Mechanismen gewährleistet. Zu den statischen Stabilisatoren zählen die knöcherne Konfiguration von Glenoid und Humeruskopf, das Labrum glenoidale, die Gelenkkapsel und der Bandapparat. Die dynamischen Stabilisatoren umfassen die Muskeln der sog. Rotatorenmanschette, die lange Bizepssehne und teilweise auch den Deltamuskel.

Der wesentliche Vorteil der Schulterarthroskopie gegenüber offenen Verfahren liegt darin, dass die anatomischen Strukturen exakt dargestellt werden können und ihre Funktion während einer dynamischen Untersuchung beurteilt werden kann. Die im Rahmen einer Schulterluxation möglichen Verletzungen des Labrums im superioren (SLAP) und anteroinferioren Bereich (Bankart, ALPSA, GLAD), Kapselverletzungen (HAGL), begleitende Knorpelläsionen (Hill-Sachs-Delle), Läsionen im Bereich des Rotatorenintervalls oder der sog. Pulley-Schlinge lassen sich exakt diagnostizieren und entsprechend arthroskopisch behandeln.

Abstract

For the diagnosis and therapy of shoulder diseases a detailed knowledge of the anatomical structures and their functional importance is fundamental. Shoulder stability is maintained through a complex interplay between dynamic and static mechanisms. The static mechanisms include the bony configuration of the glenoid and humeral head, the glenoid labrum, the capsule and ligaments. The dynamic stabilization mechanisms are the muscles of the rotator cuff, the long head of biceps muscle and partly the deltoid muscle.

The main advantage of shoulder arthroscopy over open procedures is due to the fact that anatomical structures can be also evaluated during dynamic examinations. In the context of shoulder instability, injuries of the glenoid labrum superiorly (SLAP) or anterior-inferior (Bankart, ALPSA, GLAD), capsular lesions (HAGL), accompanying cartilage lesions (Hill-Sachs), rotator interval tears and pulley lesions can be exactly diagnosed and accordingly treated.

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Authors and Affiliations

  1. Abteilung und Poliklinik für Sportorthopädie, Technische Universität München

    T. Tischer,  H. Anetzberger & A. B. Imhoff

  2. Anatomische Anstalt, Ludwig-Maximilians-Universität München

    M. Müller-Gerbl

  3. Abteilung und Poliklinik für Sportorthopädie, Technische Universität, Connollystraße 32, 80809 , München

    H. Anetzberger

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  1. T. Tischer
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  2. H. Anetzberger
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  4. A. B. Imhoff
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Correspondence to H. Anetzberger.

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Tischer, T., Anetzberger, H., Müller-Gerbl, M. et al. Arthroskopisch relevante Anatomie der Schulterinstabilität. Arthroskopie 17, 133–138 (2004). https://doi.org/10.1007/s00142-004-0262-2

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