Arthroskopische Rekonstruktion der Subscapularissehne
Tóm tắt
Verletzungen der Subscapularissehne werden klinisch häufig übersehen. Relevante Rupturen haben allerdings eine erhebliche und nicht kompensierbare Dezentrierung und Funktionseinschränkung der Schulter zu Folge. Spezifische klinische Tests und moderne Schnittbildgebung führen zur Diagnose und präoperativen Klassifikation. Die Arthroskopie ermöglicht eine präzise Diagnostik und Klassifikation der Sehnenläsionen, wobei neben der intraartikulären Beurteilung bei höhergradigen Rupturen auch eine extraartikuläre Visualisierung der Subscapularissehne und der benachbarten Strukturen erforderlich ist. Die arthroskopische Rekonstruktion von Subscapularissehnenrupturen setzt nicht nur ein präzises anatomisches Verständnis und fortgeschrittene arthroskopische Fertigkeiten voraus, sondern sie erfordert neben der Technik der Refixation vor allem ein suffizientes Release der Sehnenstrukturen. Angaben zu Resultaten nach arthroskopischer Refixation sind in der Literatur noch spärlich vorhanden. Unter Beachtung der Klassifikation und der damit verbundenen Indikationsgrenzen lassen sich nach eigener Erfahrung gute Ergebnisse erzielen.
Tài liệu tham khảo
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