Description
At the shoulder joint the ball-like head of the humerus fits into the cup-like end of the scapula (known as the "glenoid" or "shoulder socket"). The joint is held together by the shoulder capsule. This is reinforced by ligaments, which connect bone to bone and reinforce the capsule. When the humerus is forced out of the glenoid, whether by a fall on an outstretched arm, direct trauma to the area, or other injury, a dislocation occurs. A dislocation may cause the ligaments that join the humerus to the glenoid to tear away from their base on the humerus. This is known as a HAGL lesion, or Humeral Avulsion of the Glenohumeral Ligaments. It may be accompanied by a SLAP Lesion, Labral Tear, or a tear of the rotator cuff tendons.
Symptoms and Signs
The patient will feel symptoms of a dislocation or rotator cuff tear, as one of the two will be the cause of the HAGL lesion and an over-riding stimulus of pain.
Causes and Risk Factors
Causes Excess motion of the humerus within the glenoid by repeated throwing or similar motions may cause the labrum to tear. An acute injury, often resulting from a fall on an outstretched hand, can cause the condition as well. Risk Factors Frequent anterior (frontward) subluxation or acute dislocation pose the greatest risk for a HAGL Lesion.
Treatment
If pain is the main symptom take pain killers like Paracetamol. If the condition is not painful, but there is a catching sensation, consult your Orthopaedic surgeon.
Procedures
If the problem persists, an orthopedic surgeon may decide to stitch the ligaments together and attach them to the humerus. While operating on the shoulder, he or she may stabilize the shoulder arthroscopically, thermally, or through an open-shoulder approach. Suture of the gleno humeral ligaments needs an open approach to safely visualize the anatomy and place sutures.
Prevention
Strengthening the area around the shoulder, especially the rotator cuff muscles, makes for greater shoulder stability, and, thus, a reduced risk of a HAGL Lesion. Walking on slippery floors and improper falling also raise the risk of an injury to the shoulder. |
