Glenohumeral Ligaments, ligaments of the shoulder - Everything You Need To Know - Dr. Nabil Ebraheim
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- čas přidán 7. 09. 2024
- Dr. Ebraheim's animated educational video describing the glenohumeral ligaments of the shoulder.
The superior, middle, and inferior glenohumeral ligaments play different roles in the stability of the humeral head, depending on arm position and degree of rotation.
The SGHL runs from the anterosuperior labrum to the humerus.
Function:
Resists anterior translation of adducted arm.
The MGHL runs from the anterosuperior glenoid, arising just inferior o the superior GHL, to the anterior aspect of the anatomic neck of the humerus.
Function: resists anterior and posterior translation in the midrange of arm abduction at 45 degrees and external rotation.
The IGHL (anterior and posterior bands) run from the inferior two-thirds of the glenoid labrum to the lateral humerus.
Function:
Resists anterior-inferior translation of the arm in 90 degrees abduction and external rotation.
The anterior band of the IGHL forms a weak link that predisposes to Bankart lesions. The IGHL (posterior band) resists posterior-inferior translation in adduction and internal rotation. Tightness of the posterior band leads to internal impingement and increased shear forces on the superior labrum.
1.Comma Sign
a.The superolateral margin of the subscapularis is identified by “comma sign” during surgery.
b.The comma sign fibers are oriented perpendicular to the fibers of the subscapularis tendon.
c.The common sign consists of the coracohumeral ligament (CHL), the superior glenohumeral ligament (SGHL), and the medial sling of the biceps.
d.These make one structure that marks the superiorinterval of the lateral subscapularis tendon.
e.These three structures can tear from the humerus, but remain attached to each other.
f.This comma sign helps in identification of the subscapularis tendon during its arthroscopic repair.
2.Buford complex
a.Normal anatomical variant
b.A cord-like middle glenohumeral ligament and absent anterosuperior labrum
c.Looks like a SLAP tear but it is not a SLAP tear.
3.Bankart Lesion
a.Bankart lesion is the most common lesion of anterior shoulder instability following anterior shoulder dislocation
b.It involves avulsion of the anterior inferior labrum.
c.Bankart lesions are typically located in the 3-6 o’clock position because this is where the humeral head dislocates.
d.This is also the area where the anterior band of the inferior glenohumeral ligament inserts.
e.Bankart lesions can be either bony or fibrous.
4.ALPSA Lesions
a.The labral ligament complex is displaced medially and shifted inferiorly.
b.The labrum is displaced by the inferior glenohumeral (IGHL) ligament and the labrum is rolled up like a sleeve with an intact anterior scapular periosteum.
5.GLAD Lesion
a.GLAD lesion is a tear of the anterior inferior labrum (non-displaced) with avulsion of the adjacent glenoid cartilage.
b.This lesion results from impaction of the humeral head against the glenoid. This is caused by abduction and external rotation injury.
c.In the GLAD lesion, the labrum is not detached and there is no capsular stripping.
6.HAGL Lesion
a.The position of the inferior glenohumeral ligament (IGHL), which is the most important and strongest ligament, limits anterior/inferior subluxation of the humeral head.
b.Humeral avulsion of the glenohumeral ligament (HAGL) may occur due to shoulder dislocation.
c.The inferior glenohumeral ligament avulses from the inferior humeral neck (HAGL lesion)
d.HAGL lesions usually occur due to anterior shoulder dislocation caused by combined hyperabduction and external rotation of the arm.
e.It looks like the capsule and the ligament is avulsed from the inferior humeral neck and ripped off.
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May Allah give you high ranks in jannah, love you so much
You are an honourable doctor and teacher .
My professor told me he was going to quiz me about shoulder dislocation and associated shoulder ligaments... I couldn't quite grasp my head around the pictures in the textbooks, but your video really helped me understand the anatomical relations of ligaments! Thanks a lot!!
Good luck with your job
Wish I could give more than one ‘like’ 😅
Excellent in every way...thank you Dr. Ebraheim!
Very interesting and fantastic illustrations
Thank you Dr Ebrahim
as always........beautiful
Excellent video. Thanks a lot
مبدع وجزاك الله خير
Excellent , Doc!
Muchas gracias. Es muy didactico. Patricia.
I tore some of these, along with my labrum. I also had glenoid bone loss and a hill sachs lesion. Currently 2 weeks post op latarjet. Take care if your shoulders folks.
Interesting to know how this happened from someone stressed out about going to the ortho for a diagnosis.
@@cayrick swinging a sledgehammer 15 years ago. Then, I just let the injury go and experienced countless dislocations. The most recent was last fall when I fell going down the stairs and landed on my elbow. This injury haunted me for years. Hoping this surgery finally fixes it.
@@GameTime-lp7nq how were you diganosed this injury?
@@batman-sr2px Hey man, I did an MRI at my local hospital 1 year ago and all it picked up was a hill sachs lesion and tendinosis in my supraspinatus tendon. I ended up getting sent to the Holland Orthapeadic Centre in Toronto and underwent a physical exam with a surgeon and he reviewed my MRI and confirmed I would need surgery to correct the instability, however he had me do another MRI which picked up the torn labrum and ligaments. The surgeon then mentioned the 2 procedures - arthroscopic bankart and remplissage or latarjet. I then underwent a CT scan to see if I had bone loss as a result of my dislocations. According to the CT scan, I had a hill sachs lesion, along with anterior and posterior glenoid bone loss. I was then scheduled for a latarjet surgery. I am now 9ish weeks post op. Still experiencing some stiffness and light pain but making progress every day. Sticking to my exercises 2-3 times a day, in addition to physio, has worked wonders. Hoping to be back in the gym in 6 months (fingers crossed).
@@GameTime-lp7nq how was your range of motion throughout the years? Like what caused you pain before the surgery.
thank you
which arm exercise do we do to recover from this shoulder ligament ? can you share with us please :) thank you dr. nabil
Found out today I have a Posterior HAGL. I have a good relationship with my surgeon who said he has never seen this in his years of practice. I am trying to research but really only ding references to anterior HAGL. Is the treatment the same? My surgeon said he will speak to some other surgeons to get me more information moving forward but doesn’t anticipate this being able to be repaired arthroscopically. Do you have any experience with a posterior tear?
انت شخص رائع
GLENOHUMERAL JOINT DISK AND LIGAMENTS|SHOULDER COMPLEX PART 7|DR. SHAHEEN ALAM (PT)-I have tried to explain the same..kindly give your feedback
Thank you very helpful information
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