Diagnostik und Therapie der vorderen Erstluxation der Schulter

A detailed history of the patient and a physical examination of both shoulder joints are imperative to differentiate between traumatic and atraumatic shoulder dislocations. Therapeutic options to stabilize the shoulder range from functional therapy and immobilization to arthroscopic or open surgery. Young patients (< 30 years) with a traumatic first-time anterior shoulder dislocation, unidirectional instability, a Hill-Sachs-lesion, and sports activity should be treated surgically. The surgical principle consists of a refixation of the torn labrum and the anterior band of the inferior glenohumeral ligament to the anterior glenoid rim. Repair of the capsule-labrum-complex is feasible with various arthroscopic fixation techniques. A bony Bankart-lesion leads to a high reluxation rate and should be treated with an open screw osteosynthesis.