Chapter 3 Instability

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CHAPTER 3 | Instability

FIGURE 3-93  HAGL lesion. The subscapularis muscle (SSc) is visible through the rent in the capsule. H, humeral head.

FIGURE 3-95  Repaired HAGL lesion (*) and Bankart lesion. G, glenoid; H, humeral head.

■ Shoulder now hurts continuously, and the patient says that he “cannot trust it.”

The Cowboy’s Conundrum: HAGL Lesion in Extreme Inferior Location (5:30 to 6:30) The Surgeon’s Solution: Arthroscopic HAGL Repair through PosteroinferiorWorking Portal History: ■ An 18-year-old male was wrestling 6 months ago with a friend, who twisted his right arm. He felt severe pain and a pop.

Physical Exam: ■ Full range of motion and normal strength

■ Apprehension in abduction and external rotation ■ Apprehension with combined forward flexion, adduc- tion, and internal rotation

Video 3-15

Imaging: ■ X-rays are normal. ■ MRI scan suggests HAGL lesion (Fig. 3-97).

FIGURE 3-94  Repaired Bankart lesion. G, glenoid; H, humeral head.

FIGURE 3-96  View of completed HAGL repair (*) and Bankart repair. H, humeral head.