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OP-Journal 2013; 29(3): 233-239
DOI: 10.1055/s-0033-1360183
Georg Thieme Verlag KG Stuttgart · New York

Die akute Schulterinstabilität

Acute Shoulder Instability
Bastian Scheiderer
,
Christoph Bartl
,
Florian Gebhard
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Publikationsverlauf

Publikationsdatum:
07. Mai 2014 (online)

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Zusammenfassung

In Deutschland kommt es im Jahresdurchschnitt zu etwa 13 600 Schulterluxationen. Diese Zahl unterstreicht die medizinische wie auch die volkswirtschaftliche Bedeutung dieser Verletzung. Die Folge der Luxation sind Läsionen der Weichteilkomponenten sowie der knöchernen Strukturen. Diese gilt es durch eine präzise klinische und bildgebende Diagnostik zu identifizieren. Bei der Erstellung des Behandlungskonzepts müssen dabei neben den pathomorphologischen Veränderungen auch patientenbezogene Risikofaktoren berücksichtigt werden. So ging der Trend beim jüngeren oder sportlich aktiven Patienten mit einer Verletzung des Labrum-Ligament-Komplexes während der letzten Dekade hin zur operativen Stabilisierung, während beim älteren Patienten auch die konservative Therapie gute Resultate liefert. Dabei gleichen sich mittlerweile die Ergebnisse der arthroskopischen Verfahren denen der offenen an. Ausgenommen sind weiterhin große knöcherne Defekte des Humeruskopfs und der Gelenkpfanne, welche die Domäne der offenen Techniken darstellen.

Abstract

In Germany each year on average about 13 600 shoulder dislocations occur. This figure also emphasises the economic significance of this type of injury. The consequences of dislocation are not only lesions of the soft-tissue compartments, but also of the bone structures. It is essential to identify these lesions by precise clinical and imaging diagnostics. When planning the treatment concept patient-related risk factors as well as pathomorphological changes must be taken into consideration. Thus, for younger and more physically active patients with injuries of the labrum ligament complex, there has been a trend over the past decade towards surgical stabilisation whereas for older patients conservative therapy continues to provide good outcomes. In the meantime, the results of arthroscopic procedures have become similar to those of open surgery. However, large osseous defects of the humeral head and joint socket are exceptions and remain in the domain of open surgery.

 

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