shoulder dislocation

1. CHRONIC SHOULDER DISLOCATION;
PATHOANATOMY AND INVESTIGATION
& management
• PRESENTED BY :
• DR. TDS DEEPAK
• DEPARTMENT OF ORTHOPEDICS
• IGGGH & PGI PONDICHERRY

38. • An ALPSA (anterior labral periosteal
sleeve avulsion) lesion is an injury at the front
of the shoulder associated with shoulder
dislocation.

39. • The anterior (front) labrum can peel off the
glenoid resulting in a Bankart lesion. When
the periosteum (fibrous tissue surrounding
bone) peels off as well this is called an ALPSA
lesion. When this happens the labrum
(bumper) falls away and rolls up. It normally
falls medially and downwards.

41. • A GLAD (glenolabral articular disruption)
lesion is caused by a forced adduction injury
to the shoulder from an abducted and
external rotated position; patients with GLAD
lesions present with anterior shoulder pain as
their chief complaint

46. • A SLAP tear or SLAP lesion is an injury to
the glenoid labrum (fibrocartilaginous rim
attached around the margin of the glenoid
cavity). SLAP is an acronym for "superior
labral tear from anterior to posterior".

47. • Although ten varieties of SLAP lesion have
been described on MRI or MR
arthrography[5] seven clinical types are
generally described.[6]
• Type I. Degenerative fraying of the superior
portion of the labrum, with the labrum
remaining firmly attached to the glenoid rim

48. • Type II. Separation of the superior portion of
the glenoid labrum and tendon of the biceps
brachii muscle from the glenoid rim
• Type III. Bucket-handle tears of the superior
portion of the labrum without involvement of
the biceps brachii (long head) attachment

49. • Type IV. Bucket-handle tears of the superior
portion of the labrum extending into the
biceps tendon
• Type V. Anteroinferior Bankart lesion that
extends upward to include a separation of the
biceps tendon

50. • Type VI. Unstable radial flap tears associated
with separation of the biceps anchor
• Type VII. Anterior extension of the SLAP lesion
beneath the middle glenohumeral ligament

88. • Light-bulb sign
• - globular head 2° IR

159. THANK YOU