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Online ISSN 1827-1707
LA CHIRURGIA DELLA SPALLA
Mallo G. C., Golijanin P., Gross D. J., Murphy P. W., Provencher M. T.
Sports Medicine, Massachusetts General Hospital, Boston, MA, USA
The superior labral anterior-posterior tear is intimately associated with the long head of the biceps, which originates at the supraglenoid tubercle and the superior glenoid labrum. Along with the short head of biceps, they play important role in shoulder stability and the role increases as the shoulder instability increases. While it is known that the glenoid labrum itself functions to improve joint stability by creating a concavity which aids in compressive joint reactive forces and increases the effective diameter of the glenoid, the specific contribution of the superior labrum to stability is under investigation. There have been several attempts to identify the role of the superior labrum in augmenting glenohumeral joint stability, which is of particular interest for treating broad range of patients, from low demand to the elite overhead throwing athlete. Accurate diagnosis is confounded by the numerous injury mechanisms as well as the preponderance of coexisiting pathology, which makes physical exam findings difficult to interpret. Non-surgical treatment is focused on improvement of posterior capsule flexibility, strengthening the rotator cuff and scapular stabilizers, and on correcting scapular mechanics. Surgical techniques range from simple minimal debridement to extensive labral repair. Postoperative rehabilitation is guided by the type of procedure performed and post-operative patient demands.