Anatomie, Biomechanik und Klassifikation der Schultergelenkverletzung

Abstract

Movement of the shoulder joint is characterized by a complex interaction between three main joints and two subsidiary joints. The wide range of motion of this ball-and-socket joint is only possible because the socket is relatively small, the articulation surface of the glenoid being only one quarter the size of the humeral head. The kinematics of the glenohumeral joint is stabilized and controlled through the interaction of several structures: passively by bone and ligaments and actively by muscles. The ligaments of the glenohumeral joint with their mechanoreceptors have a particularly prominent role in controlling the forces that stabilize the joint. The muscles of the rotator cuff act both as stabilizer and as driver for movement, depending on the position of the arm, and are an integral element of the overall neuromuscular control system. The classifications of instabilities and lesions of the rotator cuff used in modern therapeutic practice have been adapted to the treatment options. The classification presented in this paper is based on the basic pathophysiology and clinical prognosis of the condition. © Springer Medizin Verlag 2006.