Lesions of the glenoid labrum can be associated with and cause shoulder instability and symptomatology by (1) allowing the shoulder to dislocate recurrently (ana tomical instability); (2) allowing the shoulder to sublux ate (anatomical instability); and (3) allowing the shoulder to click, catch, and lock secondary to partially attached fragments becoming interposed between the articular surfaces (functional instability). The latter two clinical entities are usually associated with "lesser" labral dam age and diagnosis can be difficult. Six illustrative cases are presented and salient diagnostic and therapeutic points are discussed. The glenohumeral axillary arthro tomogram is presented as a sensitive diagnostic test for detecting labral lesions.
Get full access to this article
View all access options for this article.
References
1.
Bankart Asb. Recurrent or habitual dislocation of the shoulder-Joint . Br Med J21132-1133, 1923
2.
Bankart Asb. The pathology and treatment of recurrent dislocation of the shoulder-joint Br J Surg2623-29, 1938
3.
Bateman JE The Shoulder and Neck. Philadelphia, WB Saunders, 1972
4.
Bateman JE The Shoulder and Neck Second edition Philadelphia , WB Saunders, 1978
5.
Blazina E., Satzman JS: Recurrent antenor subluxation of the shoulder in athletics A distinct entity J Bone Joint Surg51A: 1037-1038, 1969
6.
Booth RE, Jr, Marvel JP, Jr: Differential diagnosis of shoulder pain Orthop Clin North Am6353-379, 1975
7.
Bost FC, Inman VT The pathological changes in recurrent dislocation of the shoulder A report of Bankart's operative procedure J Bone Joint Surg24A. 595-613, 1942
8.
Braunstein EM , O'Connor G.: Double-contrast arthrotomography of the shoulder . J Bone Joint Surg64A192-195, 1982
9.
Caspari RB Shoulder arthroscopy. A review of the present state of the art Cont Orthop4523-530, 1982
10.
DePalma AF, Callery G., Bennett GA Variational anatomy and degenerative lesions of the shoulder joint . AAOS Instructional Course Lectures6: 255-281, 1949
11.
DePalma AF Surgery of the Shoulder Second edition. Philadelphia . JB Lippincott, 1973
12.
El-Khoury GY , Albnght JP, Abu Yousef MM, et al: Arthrotomography of the glenoid labrum Radiology131: 333-337, 1979
13.
Goldman AB, Ghelman B. The double-contrast shoulder arthrogram Radiology127655-663, 1978
14.
Grant Jcb. An Atlas of Anatomy, by Regions. Third edition Fig. 34. Baltimore, Williams and Wilkins, 1951
15.
Hill HA, Sachs MD The grooved defect of the humeral head A frequently unrecognized complication of dislocations of the shoulder joint Radiology35:690-700,1940
16.
Johnson LL Arthroscopy of the shoulder Orthop Clin North Am11197-204, 1980
LeClerc J. Chronic subluxation of the shoulder. In proceedings of the Dewar Orthopaedic Club J Bone Joint Surg 51B: 778, 1969
19.
McGlynn FJ, El-Khoury G., Albright JP Arthrotomography of the glenoid labrum in shoulder instability J Bone Joint Surg64A. 506-518, 1982
20.
McLaughlin HL Recurrent antenor dislocation of the shoulder Am J Surg99628-632,1960
21.
Mink JH, Richardson A., Grant TT Evaluation of glenoid labrum by double-contrast shoulder arthrography AJR133883-887, 1979
22.
Morton KS The unstable shoulder: Recurring subluxation J Bone Joint Surg59B508, 1977
23.
Moseley HF, Overgaard B. The antenor capsular mechanism in recurrent antenor dislocation of the shoulder Morphological and clinical studies with special reference to the glenoid labrum and the glenohumeral ligaments J Bone Joint Surg44B. 913-927, 1962
24.
Nelson CL, Razzano CD Arthrography of the shoulder: A Review J Trauma13136-141, 1973
25.
Neer CS, II, Foster CR Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder A preliminary report. J Bone Joint Surg62A: 897-908, 1980
26.
Pappas AM, Boland AL Internal Derangement of the Shoulder Presented to the New England Orthopaedic Society, Dorchester, Massachusetts , November 1970
27.
Perthes G. Uber operationen bei habitueller schulterluxation Deutsche Zeitschrift Chirurgie85199-227, 1906
28.
Protzman RR Anterior instability of the shoulder. J Bone Joint Surg62A: 909-918,1980
29.
Reeves B. Arthrography of the shoulder. J Bone Joint Surg48B. 424-435, 1966
30.
Rockwood CA , Jr Subluxation of the shoulder The classification, diagnosis, and treatment Orthop Trans4: 306, 1979
31.
Rokous JR, Feagin JA, Abbott HG Modified axillary roentgenogram A useful adjunct in the diagnosis of recurrent instability of the shoulder Clin Orthop8284-86, 1972
32.
Rowe CR, Pierce DS, Clark JG: Voluntary dislocation of the shoulder A preliminary report on a clinical, electromyographic, and psychiatnc study of twenty-six patients J Bone Joint Surg55A: 445-460, 1973
33.
Rowe CR, Patell D., Southmayd WW: The Bankart procedure A long term end-results study J Bone Joint Surg60A: 1-16, 1978
34.
Rowe CR, Zanns B. Recurrent transient subluxation of the shoulder J Bone Joint Surg63A: 163-172, 1981
35.
Rutledge BJ: In Treatment of Injuries to Athletes. Edited by DH O'Donoghue Philadelphia, WB Saunders, 1976, p 211.
36.
Thomson FR, Moga JJ, Fielding JW: Unusual habitual shoulder dislocation. Combined operative repair. Audiovisual presentation at the annual meeting of the AAOS New York, New York, 1965
37.
Wiley AM, Older Mwj: Shoulder arthroscopy: Investigations with a fibrooptic instrument Am J Sports Med831-38, 1980
