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Dorsale Instabilität des Schultergelenks

Posterior instability of the shoulder joint

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Zusammenfassung

Hintergrund

Schulterinstabilitäten betreffen ungefähr 2 % der Allgemeinbevölkerung. Unter den am häufigsten betroffenen Menschen finden sich oft junge, sportlich aktive Menschen. Vor allem Überkopfsportarten wie Tennis, Gewichtheben, Volleyball oder Wurfsportarten prädisponieren für die Entwicklung einer dorsalen Instabilität. Männer sind 3-mal häufiger betroffen als Frauen.

Ziel der Arbeit

Diese Übersichtsarbeit richtet den Fokus auf die Diagnosestellung und Therapie der dorsalen Instabilität.

Material und Methoden

Mittels der Suchmaschine http://www.ncbi.nlm.nih.gov wurden unter den Begriffen „shoulder“, „posterior“ und „instability“ Übersichtsarbeiten und rezenten Studien über die dorsale Instabilität des Schultergelenks ermittelt.

Ergebnisse und Diskussion

Mit einer Prävalenz von 2–10 % aller Schulterinstabilitäten wird die posteriore Schulterinstabilität oft übersehen und aus diesem Grund falsch behandelt. In der letzten Zeit wird sie jedoch in der Literatur häufiger beschrieben, mit steigender Prävalenz. Die Ursache sind meist nicht erinnerliche Mikrotraumata. Häufig steht der Schmerz bei bestimmten Bewegungen im Vordergrund, die Instabilität wird nur als sekundäres Symptom wahrgenommen. Bei geringen oder fehlenden knöchernen Defekten bietet die arthroskopische posteriore Labrumrefixation exzellente Ergebnisse. Für knöcherne Operationen ist v. a. das Defektausmaß der reversen Hill-Sachs-Läsion von Bedeutung.

Abstract

Background

Shoulder instability affects approximately 2 % of the general population. Among those most affected are young people participating in sport activities. Athletes involved in overhead sports, such as tennis, weight lifting, volleyball and throwing sports are especially predisposed to developing posterior instability of the shoulder. Men are affected three times more often than women. Compared to the much more common anterior instability, posterior instability with a prevalence of 2–10 % of all shoulder instabilities, is often overlooked and therefore incorrectly treated. Reports in the literature have recently become more frequent and the prevalence is increasing.

Aim of the work

This aim of this review article is to highlight the current topic of posterior shoulder instability and increase awareness concerning the diagnostics and therapy.

Material and Methods

By means of the search machine http://www.ncbi.nlm.nih.gov, reviews and recent studies on posterior instability of the shoulder were identified using the keywords shoulder, posterior and instability.

Results and Discussion

With a prevalence of 2–10 % of all shoulder instabilities, posterior shoulder instability is often overlooked and therefore incorrectly treated. The cause in most cases is unnoticed microtrauma. Pain during certain movements is often the main symptom and instability is perceived only as a secondary symptom. For small or no bony defects arthroscopic posterior labral repair provides excellent results. For bony operations the extent of a reverse Hill-Sachs lesion defect is primarily decisive.

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Author information

Correspondence to OA Dr. U. Lanz.

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Interessenkonflikt

L. Bauer und U. Lanz geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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M. Flury, Zürich

P. Heuberer, Wien

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Cite this article

Bauer, L., Lanz, U. Dorsale Instabilität des Schultergelenks. Arthroskopie 28, 261–266 (2015). https://doi.org/10.1007/s00142-015-0047-9

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Schlüsselwörter

  • Schulter
  • Dorsale Instabilität
  • Labrumrefixation
  • Reverse Hill-Sachs-Läsion
  • Kim’s-Test

Keywords

  • Shoulder
  • Posterior instability
  • Labral repair
  • Reverse Hill Sachs lesion
  • Kim’s test