الفهرس | Only 14 pages are availabe for public view |
Abstract *Background: Superior labrum anterior posterior (SLAP) lesion is a superior labral pathology that has been increasingly recognized with the extension of shoulder arthroscopy. (57)The mechanisms of injury may be single-event acute traumatraction or compression), or repeated throwing/overhead activity that constitutes a traction mechanism of injury. (11, 12, 31)The patho-mechanics of shoulder pain and dysfunction, the dead arm syndrome, in throwing/overhead patients is somewhat controversial. Frank Jobe et al proposed that repetitive throwing/overhead activity stretches out the anterior capsuloligamentous structures, allowing antero-superior migration during throwing/overhead activity with resultant sub-acromial impingement; advocating open anterior capsulo-labral reconstruction and reporting a 50% return to pitching in 12 pitchers. (19, 20, 21)Christopher Jobe and Walch described the concept of internal impingement. This refers to a spectrum of injury that involves the postero-superior rotator cuff and labrum, and even, bone. The underlying pathology was thought to be stretching out of the anterior capsulo-ligamentous structures. In a normal shoulder tightening of the anterior capsule such as occurs when the arm is placed in the abducted and externally rotated position results in an obligatory posterior translation of the humeral head. In the situation with lax anterior capsulo-ligamentous structures, this obligatory posterior translation was postulated not to occur, leading. |