Schultereckgelenkverletzung Typ III – eine Herausforderung auch für die Physiotherapie!

Abstract

This file was dowloaded from the institutional repository Brage NIH -brage.bibsys.no/nih Bürgi, N., Clijsen, R., Taeymans, J., Cabri, J. (2010 [1,4,6,11,12,13,24,29,33,59,62,67]. Purpose of this literature research was to evaluate the anastasis of a type III injury after conservative versus operative treatment concerning strength, function and pain of the shoulder. The authors tried to prove the possible superiority of either operative or conservative treatment and determine the reasons for the remaining unclarity.Method: Relevant studies were collected by conducting a literature search using the online databases; the selection criteria were randomized trials, clinical trials, review articles, and meta-analyses. A total of ten papers published 1998-2009 were selected and compromised six reviews and four clinically controlled studies. The analysis and comparison followed the criteria of evidence based medicine. Results:The research showed no significant superiority of neither operative nor conservative treatment although the majority of the paper's authors seem to recommend conservative intervention [6,11,12,13,33,62]. Minimal differences in outcomes concerning strength, function and pain of the shoulder justify this decision. Several reasons such as the common risks of surgery, a bigger effort and explicitly higher costs only to name some seem to be unacceptable for the possible case of minimally better outcome.The analysis and interpretation of the given studies launched a discussion about the comparability of over 150 different surgical techniques, insufficiently defined approaches of conservative treatment, differences in gender concerning anastasis, validity of measuring equipment, long term and short term results of the particular method [6,11,12,13,24,29,33,47,59,62].Discussion: At the current state of knowledge there is no gold standard for the treatment of type III acromioclavicular dislocations. To reach a consensus on which intervention should initially be chosen medicine has to respect the factors mentioned above while creating new clinically controlled studies. Furthermore the lack of guidelines for a conservative approach constitutes a challenge for future findings regarding physical therapy. Schultereckgelenkverletzung Typ III -eine Herausforderung auch für die Physiotherapie!