Posterior avulsion of the gleno humeral ligament
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This document summarizes a study on the clinical assessment and postoperative outcomes of 6 patients with posterior humeral avulsion of the glenohumeral ligament (PHAGL) who presented with anterior shoulder instability. All 6 patients developed PHAGL after a sports injury. Arthroscopic repair of PHAGL was performed and postoperative scores showed good outcomes for shoulder function and return to previous sport levels in most patients. The study concludes that PHAGL can cause anterior instability and arthroscopic repair is an effective treatment option.
Posterior avulsion of the gleno humeral ligament
- 1. 1 This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For reprints and permission queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav. Posterior humeral avulsion of the glenohumeral ligament (PHAGL) in anterior shoulder instability Franco Della Vedova, MD 1 , Maximiliano Ibáñez, MD 1 , Victoria Alvarez, MD 1 , Salvador Lépore, MD 1 , Vanina Ojeda Sulzle, MD 1 , Hernán Galan, MD 1 , Daniel Slullitel, MD, 1,2 1 Instituto de Ortopedia Traumatología Dr. Jaime Slullitel, Sanatorio de la Mujer. Dirección: San Luis 2534. Rosario. Argentina. 2 Universidad Abierta Interamericana. Av Pellegrini 1816. Rosario. Argentina. Introduction Bankart lesion is the anterior glenohumeral instability most common associated injury. Tears at glenohumeral ligaments can be intra substance or at humeral insertion, this location may be the cause of instability. Posterior humeral avulsion of the glenohumeral ligament (PHAGL) can be an isolated or associated cause of instability and it is usually related to the posterior glenohumeral instability. The aim of this article is to report the clinical assessment and postoperative outcomes of 6 patients with PHAGL with anterior shoulder instability. Materials and Methods We evaluated six patients with PHAGL due to anterior glenohumeral instability arthroscopically repaired. All 6 patients developed the lesion after a sports-related trauma. Sixty six per cent of patients had associated intra-articular shoulder pathologies. The diagnosis with MRI arthrogram (with gadolinium) was performed preoperatively in 50% of patients. Postoperative evaluation was made with Rowe, ASES and WOSI scores. Results All patients returned to their previous sports level. One patient had a recurrence. Postoperative scores results are WOSI: 13.13%, Rowe 83.33 and ASES 95.83. Discussion Humeral avulsions of glenohumeral ligaments represent 25% of capsulolabral injuries. PHAGL injury was initially described as a cause of posterior instability, but according to two other series, our study shows that this lesion may also cause anterior instability. It is critical to have a high index of suspicion and make a correct arthroscopic examination to diagnose this injury, because arthroscopic repair of PHAGL has good postoperative outcomes. The Orthopaedic Journal of Sports Medicine, 2(12)(suppl 4) DOI: 10.1177/2325967114S00249 ©The Author(s) 2014 at SAGE Publications on October 6, 2015ojs.sagepub.comDownloaded from