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Z Orthop Unfall 2024; 162(04): 360-367
DOI: 10.1055/a-2109-3190
DOI: 10.1055/a-2109-3190
Originalarbeit
Instabilitäten und Arthrose des Sternoklavikulargelenks
Article in several languages: deutsch | English
Zusammenfassung
Die Verletzung des Sternoklavikulargelenks (SCG) ist mit 3% der Schulterverletzungen und < 1% der Instabilitäten eine sehr seltene Verletzung. Folglich wird sowohl die Versorgung akuter Instabilitäten wie auch ihrer Folgezustände (chronische Instabilitäten/SCG-Arthrose) kontrovers diskutiert. Erfolgte bisher die Behandlung zumeist konservativ, so ist in den letzten Jahren eine Tendenz zur operativen Therapie zu erkennen.
Durch erhebliche Gewalteinwirkung, wie sie bei Verkehrsunfällen oder Kontaktsportarten zu finden ist, kann es zur Zerreißung des an sich äußerst stabilen Bandapparates zwischen medialer Klavikula und Sternum kommen. Während die anteriore Luxation in den meisten Fällen leichter zu reponieren ist, verbleibt in bis zu 50% der Fälle eine Instabilität. Die posteriore Instabilität bedarf in den meisten Fällen – insbesondere auch aufgrund der anatomischen Nähe zu wichtigen kardiopulmonalen Strukturen – einer raschen Reposition. Sofern dies gelingt, ist die
Rate persistierender Instabilitäten gering. Für die chronischen Instabilitäten hat sich in den letzten Jahren die Rekonstruktion/Augmentation des Bandapparates mit Sehnengrafts in der „Figure-of-8-Konfiguration“ als Standardtechnik erwiesen.
Für die Arthrose des SCG kommen OP-Techniken wie die Resektion des medialen Klavikulaendes dann in Betracht, wenn die konservative Therapie als gescheitert anzusehen ist.
Publication History
Received: 02 April 2023
Accepted after revision: 09 June 2023
Article published online:
30 August 2023
© 2023. Thieme. All rights reserved.
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