Sprengungen des Schultereckgelenks gehören zu den häufigsten Verletzungen des Schultergürtels.
Neben der Symptomlinderung stehen die Gelenkstabilisierung und Wiederaufnahme körperlicher
Aktivitäten im Vordergrund. Zur operativen Versorgung wurden minimalinvasive (arthroskopische
bzw. arthroskopisch assistierte) Techniken entwickelt, die sich gegenüber offenen
Verfahren als
mindestens gleichwertig zeigen. In diesem Beitrag sollen diese minimalinvasiven Techniken
detailliert beschrieben werden.
Abstract
Acromioclavicular joint instabilities are one of the most common injuries of the shoulder
girdle. Diagnostic measures include the vertical and horizontal components of instability.
The main
goals of treatment include pain reduction, joint stabilization, and return to physical
activity. For operative treatment, there are numerous techniques available. Recently,
minimally-invasive techniques were developed and showed equal results as with open
approach. These procedures facilitate simultaneous treatment of concomitant shoulder
lesions and reduce
soft tissue trauma as well as the risk of infection. This article presents an overview
of such minimally-invasive techniques for both acute and chronic instabilities. Both
techniques address
the aspect of horizontal instability, which was found to compromise clinical results.
For an acute injury, we describe the use of a low-profile button system combined with
an additional
acromioclavicular cerclage. In the chronic setting with a bidirectional (vertical
and horizontal) instability, a free tendon graft combined with a single TightRope
augmentation is
recommended.
Schlüsselwörter
Schultereckgelenksprengung - akromioklavikular - Instabilität - arthroskopisch - Schulter
Keywords
acromioclavicular joint - shoulder instability - arthroscopic - shoulder surgery
