Instabilitätsformen des Schultergelenks

Zusammenfassung

Anatomisch bedingt sind Instabilitätsprobleme am Schultergelenk sehr häufig. Die Bandbreite reicht von der Laxizität ohne Krankheitswert bis hin zu akuten oder chronischen Luxationen mit weichteiligen und ggf. auch knöchernen Begleitverletzungen. Entsprechend der großen Vielfalt an zugrunde liegenden Entitäten unterscheiden sich die resultierenden Therapieoptionen. Um eine optimale Behandlungsstrategie abzuleiten, ist die präzise Diagnostik unerlässlich. Im folgenden Artikel geben wir einen Überblick über die relevanten anatomischen Grundlagen, fassen wesentliche Bausteine der suffizienten Diagnostik zusammen und stellen aktuelle Therapiemöglichkeiten vor. Im Fokus stehen sowohl nicht operative Maßnahmen wie die Reposition nach akuter Schulterluxation als auch spezielle Operationsmethoden wie die arthroskopische Latarjet-Operation nach rezidivierenden Luxationsereignissen und relevantem Knochenverlust.

Types of Instability of the Shoulder Joint: Diagnostics and Therapy

For anatomic reasons instability problems at the shoulder joint are very common. The spectrum ranges from laxity without clinical significance through to acute or chronic dislocations with accompanying soft-tissue and possibly also bone injuries. As a consequence of the wide range of underlying entities there are also numerous therapeutic options. In order to determine the optimal treatment strategies an exact diagnostic work-up is mandatory. In the present contribution we give an overview of the relevant anatomic principles, summarise the essential components for an adequate diagnostic procedure and describe the current therapeutic options. The emphasis is placed not only on non-surgical interventions such as repositioning after acute shoulder dislocations but also on special surgical methods such as the arthroscopic Latarjet operation after dislocation recurrences and relevant bone deficits.

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