Abstract
Aim: To study the contribution of humeral avulsion of the glenohumeral ligaments (HAGL) to shoulder instability. Methods: In fourteen fresh cadaver shoulders a selective cutting sequence was performed. After each section an abduction-external rotation manoeuvre with axial compression and translation was carried out to provoke dislocation. The resulting instability was graded on a scale of five, ranging from no translation to a locked dislocation. Results: Cutting of only the inferior glenohumeral ligament complex resulted at the most in increased translation, but not in subluxation. For subluxation to occur, at least the middle glenohumeral ligament needed to be cut. The entire humeral capsuloligamentous complex needed to be sectioned before subluxation or dislocation occurred. In half of the cases an additional lesion of the subscapularis or the latissimus dorsi is necessary to allow a locked antero-inferior dislocation. Conclusion: Extensive damage to the humeral side of the capsulo-ligamentous complex and, frequently, associated lesions of the subscapularis or latissimus dorsi muscles are necessary to allow dislocation. This might be the primary reason for the low incidence of HAGL observed in clinical series of shoulder instability
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
