Traumatische Schultergelenkluxation

Abstract

The shoulder is the most frequently dislocated joint in humans. The emergency imaging diagnostics involve exclusion of fractures by standard x‑ray imaging. Furthermore, a neurological examination is mandatory. Following successful repositioning a radiological control is necessary. Following emergency diagnostics further procedures must be implemented to deal with any comorbidities. The standard approach to extended diagnostics is magnetic resonance imaging (MRI). Computed tomography (CT) is routinely performed if the question of bony injuries arises. The therapeutic approach is currently the domain of arthroscopy. No significant advantages of an earlier initiation of surgery could be demonstrated with respect to the results or complications; however, in general an operation should be carried out as early as possible in order to prevent the establishment of any posttraumatic instability. The main aim of surgery is essentially the reconstruction of structures damaged by the dislocation, while the postoperative approach is immobilization and initial limited passive assisted physiotherapy. Conservative treatment can also be included. Initially, this consists of immobilization and accompanying physiotherapy, in a similar manner to the postoperative procedure; however, in order to be able to carry out a successful conservative therapy, the patient’s individual need must be taken into account. Therefore, the conservative approach should not be offered to patients who are active in sports or an occupation involving overhead work but should be reserved more for elderly patients.