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Knöcherne Begleitverletzungen nach Schulterluxation

Bedeutung und Behandlung

Associated bone lesions following shoulder dislocation

Significance and treatment

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Knöcherne Begleitläsionen nach Schulterluxation, sowohl an der humeralen als auch an der glenoidalen Gelenkfläche sind Risikofaktoren für eine persistierende Instabilität, für eine Bewegungseinschränkung oder stellen eine präarthrotische Deformität dar. Arthroskopische Stabilisierungen zeigen gleiche Resultate wie offene, wenn keine knöchernen Begleitläsionen bestehen. Entscheidend ist, diese Läsionen zu erkennen und richtig einzuschätzen. Die anatomische Rekonstruktion schafft die besten Voraussetzungen für ein gutes Ergebnis. Abhängig von der Ausdehnung und Lokalisation werden frische Läsionen rekonstruiert. Sowohl für Hill-Sachs-Läsionen (reguläre und reverse) als auch für knöcherne Bankart-Läsionen sind arthroskopische Verfahren erfolgreich. Chronische Läsionen und größere Defekte werden eher offen und eventuell durch Knochenersatz korrigiert.

Abstract

Osseous deficiencies after dislocation of the shoulder, whether on the humeral or on the glenoidal side, are risk factors for persistent or recurrent instability and/or restricted motion, or herald the development of osteoarthritis. Arthroscopic shoulder repairs for the correction of instability produce results comparable to those yielded by open procedures in the absence of associated larger, relevant bone lesions. It is important that these lesions are recognised and correctly classified. Anatomical reconstruction is the best option in terms of stability and range of motion. In the case of acute lesions of limited size reconstruction is indicated. Arthroscopic procedures are successful both for Hill-Sachs lesions (regular and reverse) and for glenoid rim fractures. In the case of chronic lesions and larger defects, reconstruction by means of open procedures or perhaps grafting is preferable.

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  1. CA Unfall-, Schulter- und Handchirurgie, Krankenhaus Agatharied, St. Agathastraße 1, 83734, Hausham, Deutschland

    U.H. Brunner & R. Nadjar

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  1. U.H. Brunner
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  2. R. Nadjar
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Correspondence to U.H. Brunner.

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Brunner, U., Nadjar, R. Knöcherne Begleitverletzungen nach Schulterluxation. Arthroskopie 20, 193–202 (2007). https://doi.org/10.1007/s00142-007-0401-7

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