Wolf E M, Cheng J C, Dickson K
California Orthopaedic and Sports Medicine Group, San Francisco 94118, USA.
Arthroscopy. 1995 Oct;11(5):600-7. doi: 10.1016/0749-8063(95)90139-6.
The avulsion of the glenohumeral ligament labral complex at the glenoid (Bankart lesion), as well as ligamentous laxity are well known causes of anterior shoulder instability. A lesser known entity, the humeral avulsion of glenohumeral ligaments (HAGL), was studied to determine its incidence and its role in anterior glenohumeral instability. Sixty-four shoulders with the diagnosis of anterior instability were prospectively evaluated by arthroscopy for intraarticular pathology, including Bankart, capsular laxity, and HAGL lesions. Six shoulders were found to have HAGL lesions (9.3%), 11 shoulders with generalized capsular laxity (17.2%), and 47 shoulders with Bankart lesions (73.5%). In patients with documented anterior instability without a demonstratable "primary" Bankart lesion, a HAGL lesion should be ruled out. This lesion is readily recognized arthroscopically, and an appropriate repair of this lesion can restore anterior stability to the patient. The pathological anatomy of the HAGL lesion and our treatment of this lesion is discussed.
肩胛盂处盂肱韧带盂唇复合体的撕脱（Bankart损伤）以及韧带松弛是众所周知的前肩不稳的原因。一种鲜为人知的情况，即盂肱韧带的肱骨撕脱（HAGL），被研究以确定其发生率及其在前盂肱关节不稳中的作用。对64例诊断为前不稳的肩部进行了关节镜检查，以评估关节内病变，包括Bankart损伤、关节囊松弛和HAGL损伤。发现6例肩部有HAGL损伤（9.3%），11例肩部有广泛性关节囊松弛（17.2%），47例肩部有Bankart损伤（73.5%）。在有记录的前不稳且无明显“原发性”Bankart损伤的患者中，应排除HAGL损伤。该损伤在关节镜下很容易识别，对该损伤进行适当修复可恢复患者的前稳定性。本文讨论了HAGL损伤的病理解剖及我们对该损伤的治疗。
