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Arthroskopische Stabilisierung einer antero-inferioren Schulterinstabilität mit begleitender Hyperlaxität bei einem 10-jährigen Mädchen

Ein „case report” und „review” der Literatur

Arthroscopic stabilization of antero-inferior shoulder instability with concomitant hyperlaxity in a 10-year-old girl

Case report and review of the literature

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Zusammenfassung

Wir berichten über den seltenen Fall einer rezidivierenden antero-inferioren Schulterluxation bei einem 10-jährigen Mädchen mit begleitender Hyperlaxität. Nach geschlossener Reposition der verhakten Luxation und Einleitung der konservativen Therapie kam es, trotz Ruhigstellung im Schlingenverband, zu mehreren Rezidivluxationen. Aufgrund der rezidivierenden Luxationen und der funktionellen Beeinträchtigung wurde eine Arthroskopie mit antero-inferiorem und postero-inferioren Kapselshift durchgeführt. Die postoperative Nachbehandlung umfasste eine Immobilisation für 6 Wochen und anschließende Kräftigungsübungen. Im klinischen Nachuntersuchungszeitraum von bereits mehr als einem Jahr zeigte sich eine stabile Schulter mit freiem Bewegungsumfang, womit die junge Patientin ihren alltäglichen und sportlichen Aktivitäten in vollem Umfang nachgehen kann. Der vorliegende Fall zeigt, dass eine rezidivierende Schulterluxation auch bei Kindern mit begleitender Hyperlaxität, nach Versagen der konservativen Therapie, einen operativen Eingriff erfordern kann.

Abstract

We report the rare case of a recurrent antero-inferior shoulder dislocation in a 10-year-old girl with hyperlaxity. After closed reduction of the locked dislocation and conservative treatment, multiple further dislocations occurred while the shoulder was immobilized in a sling. Arthroscopy including antero-inferior and postero-inferior capsular shift was preformed because of the recurrent locked dislocations and functional impairment. Postoperative rehabilitation included immobilization in a sling for 6 weeks and strengthening exercises. During the clinical follow-up of more than 12 months, the shoulder remained stable with full range of motion and return to previous activities and sports. The present case illustrates that recurrent dislocation of the shoulder in children can require surgical treatment even if associated with hyperlaxity after a course of failed conservative treatment.

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Authors and Affiliations

  1. Abteilung für Unfallchirurgie, Universitätsklinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland

    F. Martetschlaeger

  2. Orthopädische Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland

    J. Kircher

  3. Zentrum für Schulter- und Ellenbogenchirurgie, ATOS Klinik Heidelberg, Heidelberg, Deutschland

    P. Magosch, S. Lichtenberg & P. Habermeyer

Authors
  1. F. Martetschlaeger
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  2. J. Kircher
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  3. P. Magosch
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  4. S. Lichtenberg
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  5. P. Habermeyer
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Correspondence to F. Martetschlaeger.

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Martetschlaeger, F., Kircher, J., Magosch, P. et al. Arthroskopische Stabilisierung einer antero-inferioren Schulterinstabilität mit begleitender Hyperlaxität bei einem 10-jährigen Mädchen. Obere Extremität 5, 229–233 (2010). https://doi.org/10.1007/s11678-010-0093-x

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