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Schultereckgelenksprengungen

Wann und wie sollten sie behandelt werden?

Acromioclavicular joint dislocation

When and how should it be treated?

  • Leitthema
  • Published:
Trauma und Berufskrankheit

Zusammenfassung

Hintergrund

Schultereckgelenk(ACG)-Sprengungen stellen ein häufiges Verletzungsbild der Schulter dar. Die heute mehrheitlich verwendete Klassifikation nach Rockwood beruht vorrangig auf der Graduierung der vertikalen Translation. Jedoch sollte eine dynamische horizontale Translation berücksichtigt und bei operativer Versorgung auch adressiert werden. Bei einer Typ-III-Verletzung nach Rockwood besteht derzeit keine klare Evidenz hinsichtlich einer konservativen oder operativen Versorgung. Darüber hinaus fehlt eine einheitliche evidenzbasierte Einteilung der akuten oder chronischen Situation, insbesondere was den besten Zeitpunkt für eine operative Versorgung angeht.

Methoden

In den letzten Jahren wurden für die Stabilisierung des ACG zunehmend arthroskopische Techniken angewendet. Diese ermöglichen die Detektion und Versorgung von möglichen Begleitpathologien, ferner lässt sich in den meisten Fällen der sonst obligate Eingriff zur Materialentfernung vermeiden.

Abstract

Background

Acromioclavicular joint (ACJ) dislocation is a common injury of the shoulder girdle. Based on the classification according to Rockwood the severity is mainly graded according to vertical translation; however, dynamic horizontal translation should also be taken into account and should be addressed in cases of surgical treatment. Regarding a type III injury according to Rockwood there is no clear evidence that favors conservative or surgical treatment. Furthermore, a common, evidence-based classification of the acute or chronic situation, especially regarding the optimal point in time for surgical treatment, is lacking.

Methods

In recent years arthroscopic techniques for acute ACJ stabilization have evolved with the ability to detect and treat possible accompanying glenohumeral pathologies and with the avoidance of an obligatory implant removal in the majority of techniques.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. N. Kraus, M. Minkus und M. Scheibel geben an, dass kein Interessenkonflikt besteht. Alle in diesem Beitrag beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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  1. Centrum für Muskuloskeletale Chirurgie, Charité – Universitätsmedizin Berlin, Campus Mitte und Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland

    N. Kraus, M. Minkus &  M. Scheibel

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  1. N. Kraus
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  2. M. Minkus
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  3. M. Scheibel
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Correspondence to M. Scheibel.

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Kraus, N., Minkus, M. & Scheibel, M. Schultereckgelenksprengungen. Trauma Berufskrankh 16, 251–257 (2014). https://doi.org/10.1007/s10039-014-2147-6

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