SLAP lesions of the shoulder上肩盂唇由前向后剥离病灶.pptVIP

SLAP lesions of the shoulder上肩盂唇由前向後剝離病灶 報告學生: 陳明媛 指導老師: 劉玫舫老師 報告日期: Jan 16, 2010 INTRODUCTION Anatomy of glenohumeral joint The superior labrum is functionally important as an anchor for the insertion of the biceps tendon on the glenoid rim What is SLAP lesions ? SLAP = superior labrum anterior posterior Prevalence MECHSNIDM of INJURY Common mechanisms of injury include microtrauma secondary to repetitive overhead or hyperextension arm motion, found in throwers and swimmers direct trauma due to falling on the outstretched arm in the acute setting. heavy lifting (1995, Maffet ) Associated lesions Incidence of associated intra-articular disease included An isolated SLAP lesion: 28% Partial rotator cuff tears: 29% Full rotator cuff tears: 22% Bankart lesions: 22% Glenohumeral chondromalacia: 10% (1995, Snyder et al.) DIAGNOSIS History and symptoms Clinical history: Involved a traction injury, direct trauma to the shoulder, or fall on an outstretched arm. Physical examination OBriens active compression test Crank test Speed’s test The Resisted supination external rotation (supination/ER) test Radiographic test CLASSIFICATION Development and principles Character of each type Operative treatment POST-OP PHYSICAL THERAPY Rehabilitation protocol Rehabilitation consideration Outcome SUMMARY References Powell SE, Nord KD, Richard KN. The diagnosis, classification, and treatment of SLAP lesions. Oper Tech Sports Med 2004;12:99-110. Cohen BS, Romeo AA, Bach BR. Clinical orthopaedic rehabilitation. In: Brotaman SB, Wilk KE, editors. Shoulder injuries. 2nd ed. Memphis, Tennessee: Mosby; 2003:234-240. Meserve BB, Cleland JA, Boucher TR. A meta-analysis examining clinical test utility for assessing superior labral anterior posterior lesions. Am J Sports Med 2009;37:2252. Mypers TH, Zemanovic JR, Andrews JR. The resisted supination external rotation test: A new test for the diagnosis of superior labral anterior posterior lesions. Am J Sports Med 200