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Schulterchirurgie in der Praxis pp 87–109Cite as

Multidirektionale Schulterinstabilität

Klassifikation, Klinik, Differentialdiagnose, Behandlungsmethoden

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Zusammenfassung

Die operative Therapie der Schulterinstabilität erlebte in den letzten Jahren einen enormen Wandel. Zusätzlich zur Wiederherstellung der Stabilität und Minimierung der Reluxationsrate wird vor allem bei sportlich aktiven Patienten zunehmend auf die Bedeutung der Kraft und der vollen postoperativen Beweglichkeit Wert gelegt. Neben den etablierten offenen Operationsmethoden (z.B. Kapselshift nach Neer) gelingt dies vor allem durch die exakte Rekonstruktion der anatomischen Verhältnisse mittels der arthroskopischen OP-Technik [42]. Als sehr komplexes Problem im Hinblick auf Diagnostik und Therapie stellen sich Schulterinstabilitäten dar, die in verschiedene Richtungen ausgeprägt sind. Diese multidirektionalen Instabilitäten (MDI) sind mit 2 % der Gesamtzahl aller Instabilitäten relativ selten und wurden früher in der Regel konservativ therapiert. Aber nicht zuletzt aufgrund der Kenntnis von Übergangsformen zwischen diesen multidirektionalen und den häufigen unidirektionalen Instabilitäten tritt die operative Therapie immer mehr in den Vordergrund [7, 9, 13, 17, 24, 47, 57-59, 64, 71, 75]. Um die optimale Therapieform einzusetzen, ist die Kenntnis der Begriffe Laxität und Instabilität sowie die Kenntnis einer differenzierten Klassifikation der Schulterinstabilität Vorraussetzung [24, 78].

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Authors
  1. U. König
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  2. A. B. Imhoff
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Editors and Affiliations

  1. Kantonsspital Baden, Orthopädisch-traumatologische Abteilung, CH-5404, Baden, Schweiz

    Rainer-Peter Meyer

  2. Kantonsspital St. Gallen, Klinik für orthopädische Chirurgie, CH-9007, St. Gallen, Schweiz

    André Gächter

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König, U., Imhoff, A.B. (2001). Multidirektionale Schulterinstabilität. In: Meyer, RP., Gächter, A. (eds) Schulterchirurgie in der Praxis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56427-7_8

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  • DOI: https://doi.org/10.1007/978-3-642-56427-7_8

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