shoulder

Shoulder

Approaches

 

Anterior

Anterolateral

Posterior

 

Anterior Approach / Deltopectoral

 

Indications

- shoulder stabilization

- arthroplasty

- fracture fixation

 

Approach

 

Position

- beach chair

- upper body elevated 30- 40o / reduces venous pressure and bleeding

Throwing Athlete

Throwing

 

Wind-up

- cocking

- ER up to 180o in pitcher

 

Acceleration

- large scapular muscles 

- acceleration - 7000o/sec

- rotatory acceleration similar to car tyre at 130 kph

 

Control and deceleration

- fragile cuff & glenohumeral ligament complex 

 

Anatomy

 

HAGL

DefinitionHAGL Arthroscopy

 

Humeral Avulsion of Glenohumeral Ligament

 

Incidence

 

Bokor et al JBJS Br 1999

- 514 cases surgical treatment traumatic instability

- incidence 7.5%

- 25% associated SSC tear

- likelihood of HAGL if no Bankart or MDI 27%