Korakoid- und Akromionfrakturen View Full Text


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Article Info

DATE

2018-02

AUTHORS

J. C. Katthagen, M. J. Raschke, B. Schliemann

ABSTRACT

Frakturen des Korakoids und des Akromions sind selten. Verbesserte diagnostische und therapeutische Möglichkeiten haben zu einer Weiterentwicklung der Versorgung dieser Frakturen geführt. Aktuelle Therapieempfehlungen werden dargelegt. Es erfolgt eine Auswertung der aktuellen nationalen und internationalen Literatur. Korakoidfrakturen proximal der korakoklavikulären Bänder und Korakoidfrakturen mit Begleitverletzung weiterer Anteile des „superior shoulder suspensory complex“ (SSSC) werden in der Regel operativ behandelt. Undislozierte, isolierte und insbesondere distale Korakoidfrakturen sind eine Domäne der konservativen Therapie. Bei den Akromionfrakturen muss zwischen zwei Entitäten unterschieden werden: Während die einfache Akromionfraktur meist traumatischer Genese ist, handelt es sich bei der Fraktur bei inverser Prothese um eine Art Ermüdungsbruch durch erhöhte Stresskonzentration am Akromion. Weit ventral gelegenen Avulsionen und undislozierte Ermüdungsfrakturen des Akromions werden meist konservativ behandelt. Insbesondere bei relevanter Einengung des Subakromialraums sowie bei funktioneller Insuffizienz der Deltamuskulatur kommen operative Verfahren zur Anwendung. Die operative Therapie der Korakoidfrakturen erfolgt meist mittels direkter Schraubenosteosynthese, insbesondere bei Beteiligung des Glenoids zunehmend als arthroskopisch gestütztes Verfahren. Die operative Therapie von Akromionfrakturen umfasst je nach Art und Lokalisation der Fraktur Schrauben‑, Zuggurtungs- und Plattenosteosynthesen. Bei der Therapie der Akromion- und Korakoidfrakturen spielen die Integrität des SSSC sowie die funktionelle Kompromittierung der individuellen Schulter eine entscheidende Rolle. Die zunehmende Anwendung arthroskopisch assistierter Verfahren erweitert die operativen Möglichkeiten. More... »

PAGES

21-31

References to SciGraph publications

Journal

TITLE

Arthroskopie

ISSUE

1

VOLUME

31

Author Affiliations

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00142-017-0171-9

DOI

http://dx.doi.org/10.1007/s00142-017-0171-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1092245145


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35 schema:description Frakturen des Korakoids und des Akromions sind selten. Verbesserte diagnostische und therapeutische Möglichkeiten haben zu einer Weiterentwicklung der Versorgung dieser Frakturen geführt. Aktuelle Therapieempfehlungen werden dargelegt. Es erfolgt eine Auswertung der aktuellen nationalen und internationalen Literatur. Korakoidfrakturen proximal der korakoklavikulären Bänder und Korakoidfrakturen mit Begleitverletzung weiterer Anteile des „superior shoulder suspensory complex“ (SSSC) werden in der Regel operativ behandelt. Undislozierte, isolierte und insbesondere distale Korakoidfrakturen sind eine Domäne der konservativen Therapie. Bei den Akromionfrakturen muss zwischen zwei Entitäten unterschieden werden: Während die einfache Akromionfraktur meist traumatischer Genese ist, handelt es sich bei der Fraktur bei inverser Prothese um eine Art Ermüdungsbruch durch erhöhte Stresskonzentration am Akromion. Weit ventral gelegenen Avulsionen und undislozierte Ermüdungsfrakturen des Akromions werden meist konservativ behandelt. Insbesondere bei relevanter Einengung des Subakromialraums sowie bei funktioneller Insuffizienz der Deltamuskulatur kommen operative Verfahren zur Anwendung. Die operative Therapie der Korakoidfrakturen erfolgt meist mittels direkter Schraubenosteosynthese, insbesondere bei Beteiligung des Glenoids zunehmend als arthroskopisch gestütztes Verfahren. Die operative Therapie von Akromionfrakturen umfasst je nach Art und Lokalisation der Fraktur Schrauben‑, Zuggurtungs- und Plattenosteosynthesen. Bei der Therapie der Akromion- und Korakoidfrakturen spielen die Integrität des SSSC sowie die funktionelle Kompromittierung der individuellen Schulter eine entscheidende Rolle. Die zunehmende Anwendung arthroskopisch assistierter Verfahren erweitert die operativen Möglichkeiten.
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