Geschlossene und operative therapieverfahren bei schulterluxationen

Abstract

Shoulder dislocations are common. Young male patients especially have a very high risk of persistent or recurrent instability (about 87%) within the first 2 years after nonoperative treatment following trauma. Posttraumatic immobilisation in external rotation might be a better option to prevent redislocation. We recommend a gentle method of reduction, such as Stimson's technique, which can be performed by manipulating the scapula with the patient in the prone position. Surgical treatment needs to be adapted to the underlying pathology, the patient's age, and the patient's individual demands. According to the literature, the gold-standard technique for refixation of a torn capsular-labrum complex, with regard to redislocation rate, is still the open Bankart procedure. However, in the hands of an experienced surgeon, the results of arthroscopic stabilisation seem very promising; the functional results especially appear to be superior to open techniques. Over the last years, arthroscopic fixation techniques have improved steadily. Using knotless anchors, it is now possible to perform sufficient arthroscopic capsular shifts. © 2008 Springer Medizin Verlag.