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Partialrupturen der Supraspinatus- und Subskapularissehne

Partial rupture of the supraspinatus and subscapular tendons

  • Leitthema
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Arthroskopie Aims and scope

Zusammenfassung

Läsionen der Subskapularissehne treten häufig zusammen mit Läsionen der Supraspinatus- sowie der langen Bizepssehne auf. Klinische und bildgebende Verfahren sind bei Partialläsionen häufig nicht eindeutig, so dass sie auch als Zufallsbefunde bei der Arthroskopie auftreten können. Die operative Behandlung dieser anterosuperioren Partialrupturen erfolgt heute überwiegend arthroskopisch. Wegweisend für die weitere operative Therapie ist die intraoperative Unterscheidung zwischen signifikanten und nichtsignifikanten Partialläsionen. Nichtsignifikante Läsionen bedürfen lediglich eines Débridements. Signifikante kombinierte Partialläsionen der Supraspinatus- und Subskapularissehne machen jedoch eine technisch aufwendige Rekonstruktion beider Sehnen sowie eine Versorgung der Bizepssehne notwendig. Dieser Beitrag gibt einen Überblick über das diagnostische Vorgehen sowie eine Hilfestellung zur effizienten Planung des operativen Eingriffs mit detaillierter Beschreibung der arthroskopischen Technik.

Abstract

Lesions of the subscapularis tendon are often associated with lesions of the supraspinatus and long head of the biceps tendons. Clinical and radiographic examination can be unreliable which can lead to incidental findings of these lesions during arthroscopy. Operative treatment of anterosuperior partial tears of the rotator cuff is now mostly performed arthroscopically. An evaluation whether tears are significant or non-significant is an essential step regarding further operative treatment. Non-significant tears are usually debrided. Significant combined partial tears of the supraspinatus and subscapularis tendons require a technically demanding reconstruction of both tendons combined with treatment of the biceps tendon. The following article describes diagnostic procedures as well as aids for efficient planning and outlines the operative steps of an all-arthroscopic technique.

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  1. Klinik für Allgemeine Orthopädie und Tumororthopädie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland

    D. Liem,  C. Schmidt &  T. Vogler

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  1. D. Liem
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  2. C. Schmidt
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  3. T. Vogler
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Correspondence to D. Liem.

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Liem, D., Schmidt, C. & Vogler, T. Partialrupturen der Supraspinatus- und Subskapularissehne. Arthroskopie 25, 77–83 (2012). https://doi.org/10.1007/s00142-011-0663-y

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