SOP Schulterstabilisation

Einleitung

Die Stabilität der Schulter wird durch einen komplexen statischen (glenohumerale Ligamente und Kapsel-Labrum-Komplex) und dynamischen Weichteilmantel (Rotatorenmanschette, Bizepssehne, M. latissimus dorsi und M. pectoralis major) gewährleistet, da das Glenoid den Humeruskopf nur unzureichend umschließt.

Als Schulterinstabilität wird die Unfähigkeit bezeichnet, den Humeruskopf in der Gelenkpfanne des Schulterblatts zentriert zu halten.

Die Inzidenz einer vorderen Schulterluxation beträgt nach aktuellen Untersuchungen 23 pro 100 000 Personenjahre und ist bei jungen Männern mit 98/100 000 ungefähr 4-mal so hoch [9]. Die vordere Schulterluxation ist dabei mit 95% sehr viel häufiger als die hintere Luxation mit weniger als 3%.

• Literatur

• 1 Bayley J. The classification of shoulder instability – new light through old windows. 16th Congress of European Society of the Surgery of the Shoulder and the Elbow. Budapest, Ungarn: Elsevier; 2002
• 2 Beighton P, Solomon L, Soskolne CL. Articular mobility in an African population. Ann Rheum Dis 1973; 32: 413-418
• 3 Bigliani LU, Newton PM, Steinmann SP. et al. Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder. Am J Sports Med 1998; 26: 41-45
• 4 Cameron KL, Duffey ML, DeBerardino TM. et al. Association of generalized joint hypermobility with a history of glenohumeral joint instability. J Athl Train 2010; 45: 253-258
• 5 Hovelius L, Saeboe M. Neer Award 2008: Arthropathy after primary anterior shoulder dislocation–223 shoulders prospectively followed up for twenty-five years. J Shoulder Elbow Surg 2009; 18: 339-347
• 6 Itoi E, Lee SB, Berglund LJ. et al. The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am 2000; 82: 35-46
• 7 Itoi E, Sashi R, Minagawa H. et al. Position of immobilization after dislocation of the glenohumeral joint. A study with use of magnetic resonance imaging. J Bone Joint Surg Am 2001; 83-A: 661-667
• 8 Jakobsen BW, Johannsen HV, Suder P. et al. Primary repair versus conservative treatment of first-time traumatic anterior dislocation of the shoulder: a randomized study with 10-year follow-up. Arthroscopy 2007; 23: 118-123
• 9 Leroux T, Wasserstein D, Veillette C. et al. Epidemiology of primary anterior shoulder dislocation requiring closed reduction in Ontario, Canada. Am J Sports Med 2014; 42: 442-450
• 10 Maquieira GJ, Espinosa N, Gerber C. et al. Non-operative treatment of large anterior glenoid rim fractures after traumatic anterior dislocation of the shoulder. J Bone Joint Surg Br 2007; 89: 1347-1351
• 11 Olds M, Ellis R, Donaldson K. et al. Risk factors which predispose firsttime traumatic anterior shoulder dislocations to recurrent instability in adults: a systematic review and meta-analysis. Br J Sports Med 2015; 49: 913-922
• 12 Owens BD, DeBerardino TM, Nelson BJ. et al. Long-term follow-up of acute arthroscopic Bankart repair for initial anterior shoulder dislocations in young athletes. Am J Sports Med 2009; 37: 669-673
• 13 Paterson WH, Throckmorton TW, Koester M. et al. Position and duration of immobilization after primary anterior shoulder dislocation: a systematic review and meta-analysis of the literature. J Bone Joint Surg Am 2010; 92: 2924-2933
• 14 Sugaya H, Moriishi J, Dohi M. et al. Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg Am 2003; 85-A: 878-884
• 15 Thomas SC, Matsen 3rd FA. An approach to the repair of avulsion of the glenohumeral ligaments in the management of traumatic anterior glenohumeral instability. J Bone Joint Surg Am 1989; 71: 506-513
• 16 Wheeler JH, Ryan JB, Arciero RA. et al. Arthroscopic versus nonoperative treatment of acute shoulder dislocations in young athletes. Arthroscopy 1989; 5: 213-217
• 17 Yamamoto N, Muraki T, Sperling JW. et al. Stabilizing mechanism in bone-grafting of a large glenoid defect. J Bone Joint Surg Am 2010; 92: 2059-2066