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Slap Tears
- 1. SLAP Tears: A 2 Pronged Approach to Diagnosis and Treatment Rebecca Zahniser, PA-S, ATC Philadelphia University PA Program Master’s Project: Teaching Track April 22, 2010
- 6. Types of SLAP Tears Most Common A . Type I B . Type II C . Type III D . Type IV
- 10. O’Brien Test
- 11. Anterior Slide Test http://www.clinicalsportsmedicine.com/_images/chapters/14/14-2u.jpg
- 14. Shoulder Radiograph Views Normal unless SLAP tear is in conjunction with a shoulder dislocation
- 19. Portal Placement
- 26. Video SLAP Repair Video
- 27. Questions?
Hinweis der Redaktion
- A series of biceps provocation tests can be performed to provide additional support to the clinical diagnosis of SLAP (superior labrum anterior-posterior) tears. The shoulder is placed into an abducted and externally rotated position until symptoms are reproduced. The test is considered positive if supination of the forearm reduces symptoms (B), forearm pronation (“walks like an Egyptian”) exacerbates pain (A), or resisted elbow flexion exacerbates pain (C).
- A, Anteroposterior view of the shoulder in external rotation. B, Anteroposterior view of the glenohumeral joint (Grashey view). C, Axillary view of the shoulder. D, Scapular Y view of the shoulder. E, Stryker notch view of the shoulder.
- Oblique coronal T1-weighted images reveal various types of SLAP lesions. A, Type I SLAP tear. Abnormal signal is noted along the inferior margin of the superior labrum ( arrow ), indicating a degenerative pattern tear with no displaced or unstable fragment noted. B, Type II SLAP tear. An abnormal collection of contrast material ( arrow ) extends into the substance of the superior labrum, indicating a partial avulsion. C, Type III SLAP tear. A displaced bucket-handle fragment ( long arrow ) is seen extending off the inferior aspect of the superior labrum. Contrast ( short arrow ) completely surrounds the avulsed bucket-handle fragment. D, Type IV SLAP tear. A bucket-handle fragment ( long arrow ) is seen extending from the inferior aspect of the superior labrum, involving the biceps anchor ( short arrows ).
- 1. Arthroscopic photograph of the superior labrum. The 18-gauge spinal needle is used to localize the posterolateral portal and angle to the glenoid rim. It is preferable to establish both portals before repair is begun. 2. Arthroscopic photograph of drilling and placement of the suture anchor through a single arthroscopic guide. Note the appropriate location up on the ridge of the glenoid and angle of approach. 3. Arthroscopic photograph of passage of the anterior anchor's suture through the anterosuperior labrum just in front of the biceps root. Note use of the “bird beak” suture passer to grasp the suture. A probe through the other portal eases capture of the suture. The suture passer is removed and pulls one limb of the suture anchor through the labrum. 4. Arthroscopic photograph of a knot pusher securing the anterior knot. The same sequence of steps is then performed for the posterior anchors. 5. Arthroscopic photograph of a completed SLAP (superior labrum, anterior to posterior) repair. Note in this case that two anchors were placed posterior to the root of the biceps tendon to secure the superior labrum–biceps tendon complex to the superior glenoid.