Zusammenfassung
Bei veralteten Schultereckgelenkverletzungen spielt das Ausmaß der Schädigung der korakoklavikularen Bänder, der Akromioklavikulargelenkkapsel mit ihren Verstärkungsbändern sowie insbesondere auch der für die horizontale Stabilität wichtigen Deltotrapezoidfaszie eine große Rolle. Bisher gibt es für veraltete Schultereckgelenkverletzungen keine Klassifikation. Um Kriterien für die Therapieentscheidung zu erarbeiten, wurden prospektiv klinische, radiologische und sonographische Daten zu veralteten Eckgelenkverletzungen standardisiert erhoben, ausgewertet und eine Einteilung in 3 Typen, A, B und C, mit den 4 Untertypen B1, B2, C1 und C2, definiert. Die veralteten Verletzungen des Typs A scheinen für die Behandlung nach der einfachen Weaver-Dunn-Methode geeignet, in allen anderen Fällen ist eine zusätzliche temporäre Retention des Akromioklavikulargelenks in Kombination mit einer Rekonstruktion der Deltotrapezoidfaszie und ggf. bandplastischen Maßnahmen erforderlich.
Abstract
In old injuries of the acromioclavicular (AC) joint the extent of damage to the coracoclavicular ligaments, the AC joint capsule with its strengthening ligaments and in particular the deltotrapezius fascia which is responsible for horizontal stability play an important role. Previously there was no classification of old AC joint injuries. In order to work out criteria for therapy decisions prospective clinical, radiological and sonographic data on old AC injuries were compiled in a standardized way, evaluated and divided into three types A, B and C with four defined subtypes B1, B2, C1 and C2. Old injuries of type A seem to be suitable for treatment by the Weaver-Dunn method but for all other types an additional temporary retention of the AC joint in combination with reconstruction of the deltotrapezius fascia and sometimes ligamentoplastic measures are necessary.
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Hedtmann, A., Heers, G. Alte Akromioklavikulargelenkverletzungen. Trauma Berufskrankh 14 (Suppl 1), 12–17 (2012). https://doi.org/10.1007/s10039-011-1819-8
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DOI: https://doi.org/10.1007/s10039-011-1819-8