The pathophysiology, diagnosis, and nonsurgical management of SLAP tears are reviewed here. COMPLICATIONS OF SURGERYInjury to the posterior branch of the axillary nerve.- This branch lies within 1 mm of the inferior shoulder capsule and the glenoid rim.- It can be injured during the procedure from passing sutures into the posterior and inferior labrum.- This branch supplies the teres minor muscle and gives sensation to the lateral shoulder.Over tightening of the posterior capsule may lead to anterior subluxation of the shoulder. Found inside – Page 742Paralabral cysts are highly specific for adjacent labral tears, ... shoulder demonstrates an anterior labral tear (black arrow) and posterior labral tear ... Throwing athletes or weightlifters can experience glenoid labrum tears as a result of repetitive shoulder motion. Found insideA posterior labral tear extending from 6 - o'clock to 9 . o'clock on a right shoulder is typically repaired with suture anchors at the ... a left 45 - degree hook for a right shoulder when it is introduced from the posterior portal ) . The labral tear is identified with the arthroscope in the anterior portal and viewing the posterior shoulder. A labrum SLAP tear covers a specific area. The success rate of treating isolated symptomatic posterior labral tears without surgery is … Video Case Reports: Options for Managing Shoulder Instability, Femoral Component Revision through a DAA THA, Inspection of both shoulders reveals no asymmetry or atrophy, Palpation demonstrates mild anterior capsular tenderness, Range of motion both supine and elevated is symmetric and full, Strength testing of the rotator cuff musculature is 5/5 in all planes, Positive O’Briens active compression test, Pain with posterior load and shift test with 1+ laxity, Plain radiographs are reviewed and found to be normal (AP/Y view/axillary), MRI arthrography shows evidence of a posterior labral tear and partial undersurface rotator cuff pathology (Figure 1), Superior labral anterior posterior tear (SLAP), Humeral avulsion of the glenohumeral ligament (HAGL), Recurrent posterior subluxation, posterior shoulder instability, and labral tear without significant capsular laxity. Found inside – Page 592Nonoperative treatment of superior labrum anterior posterior tears: improvements in ... The abduction external rotation (aber) view for MRI of the shoulder. This updated 3rd edition includes highly practical guided reviews of SCOI’s latest advances in assessment and surgical technique, offering recommendations ranging from operating room layout to arthroscopy education opportunities. Increased glenoid retroversion increases the risk of posterior shoulder instability by 6 times. Traumatic posterior shoulder dislocations most often occur when significant force is placed through the arm when it is front of the body (Figure 2). With posterior instability, the patient feels instability or a slipping sensation of the shoulder and pain with posteriorly directed force or pressure. To minimize the risk of overtreatment, renewed effort should be directed toward meticulous execution of the initial clinical exam and correct diagnosis, according to Mayo Clinic orthopedic surgeon Shawn W. O'Driscoll, M.D., Ph.D. "The greatest need right now in the treatment of SLAP lesions is to raise the level of diagnostic certainty that a SLAP lesion is responsible for patients' symptoms, or the substantial contributing factor, and n… Figure 5. The labral tear will make it easier for this to happen again, which is why many elite baseball players with a batters shoulder will ultimately have surgery to repair the labral tear. X-Rays will also be taken to determine whether there is a piece of bone involved. Kim SH, Ha KI, Park JH, et al. The shoulder joint is made up of the shoulder blade (scapula), the collarbone (clavicle), and the upper arm bone (humerus). 25 Harley St The purpose of the glenoid labrum is to provide stability and shock absorption within the joint. Brownsburg, IN 46112 P 317.26.3634 • F 317.26.3695 Posterior Labral Repair Physical Therapy Protocol Phase I: Protection (Weeks 0 to 6) His initial injury was from playing basketball: He fell after a blocked jump shot and landed on an outstretched arm. Axial T2 MRI scan of a patient with a posterior labral tear. Offensive linemen, overhead athletes, and those who lift weights are particularly susceptible to injuring their shoulder in this capacity, and a high index of suspicion is warranted when treating this patient population. It is also seen in people who do a lot of throwing. Pain or instability with the arm elevated in the scapular plane occurs due to shoulder impingement. Labrum tears that require surgery usually require minimally invasive arthroscopic surgery. MRI is the best study to diagnose the posterior lesion. London The symptoms have progressed to pain with any loading of the shoulder, inability to perform push-ups, and mild nighttime symptoms. Follow me on twitter:https://twitter.com/#!/DrEbraheim_UTMCPosterior labral tear could mean posterior instability, which is usually diagnosed by the Jerk test or the Kim test. It is most commonly caused by a fall onto the arm or a direct blow e.g. A severe blow to the anterior structures of the arm results in posterior glenohumeral forces with labral detachment at the rim of the glenoid posteriorly. The two most frequent labral injuries are SLAP (Superior Labrum from Anterior to Posterior) tears and Bankart tears. A posterior labral tear is referred to as a reverse Bankart lesion, or attenuation of the posterior capsulolabral complex, and commonly occurs due to repetitive microtrauma in athletes. The patient underwent left shoulder arthroscopy with posterior labral repair and rotator cuff debridement. If symptoms persist arthroscopy will be required to repair the lesion. Bradley JP, Tejwani SG. Bankart Tears: A Bankart tear occurs during a shoulder dislocation—when the shoulder comes out of joint, the labrum is torn, and the shoulder is more susceptible to future dislocations. While physical therapy can be an initial treatment for many patients, it is not typically successful for the athlete who wishes to resume competitive sport. All physicians, coaches, trainers, strength and conditioning specialists, and therapists who care for overhead athletes at all levels of participation are sure to find this an indispensable resource. Book jacket. Found inside – Page 73SLAP 840.7 Lesion superior glenoid labrum 840.8 Tear superior glenoid ... SLAP lesion of left shoulder S43.439 SLAP lesion of unspecified shoulder Add ... Rarely the patient complains of true dislocation that needed reduction. Sign up now to receive news and updates from ICJR, delivered right to your inbox! There many different variations of SLAP tears, which have different levels of severity and treatment strategies. This technique was developed as a more anatomic repair of posterior labral tears of the shoulder. Found inside – Page 169The same axial images on the left shoulder (Fig. 13.1f–i) show a similar posterior labral tear, this time accompanied with a more patulous posterior capsule ... Found inside – Page 101.5.3 Anterior and Posterior Labral Tears Associated For athletes ... with the arm in the abducted and externally rotated position, while posterior labral ... Posterior instability of the shoulder can occur in football players, especially in blocking positions such as defensive linemen. The labrum helps to keep the ball (humeral head) in its place within the socket. Similar to a SLAP tear, a posterior labral tear can be ignored if asymptomatic. It can also occur in weight lifters and other athletes who perform overhead activities. A combined Jerk test and Kim test (positive) has a sensitivity of 97% for the diagnosis of posterior instability of the shoulder. SLAP stands for Superior Labral tear Anterior to Posterior. J Bone Joint Surg Am 2003;85-A: 1479-1487. Flexion, internal rotation and adduction will cause the shoulder to be at risk for posterior shoulder subluxation or dislocation. The patient's arm is abducted to 90 degrees, fully internally rotated and the elbow is bent. Found inside – Page 34A C B FIG 3 • AP radiographs of the left shoulder showing a dislocated ... scan in a patient with deficient glenoid labrum and subscapularis tendon tear. When the shoulder dislocates posteriorly the capsule, ligaments and labrum often tear (Figure 3). a rugby tackle. Conservative treatment provides only temporary relief. When that occurs it will cause a tear of the posterior labrum. Recurrent episodes of subluxation or pain is not uncommon. RICE is the standard treatment to reduce inflammation and swelling in the shoulder. Arthroscopic management of posterior shoulder instability. The undersurface partial rotator cuff tear is debrided with a full radius shaver device. Figure 6. Examination under anesthesia revealed 2+ posterior drawer and trace positive inferior sulcus. This comprehensive, practical volume is enhanced with striking illustrations, detailing the surgical technique from positioning to closure. Found inside – Page 138... a posterior labral tear is associated with a superior labral tear, resulting in the type VIII SLAP tear.26 Accordingly, when examining a shoulder ... This website stores cookies on your computer. In a labrum SLAP tear, SLAP stands for superior labrum … The most studied injury to the labrum is the superior labral anterior-posterior (SLAP) tear. There was a posterior labrum tear. Exercises that stretch … When a tear is a combination of Bankart , Reverse Bankart tear and SLAP tear , it is known as a 270 degree tear: . SLAP tears occur at the front of the upper arm where the biceps tendon connects to the Surgical Technique. Found inside – Page 238... shoulder while in abduction levers the humeral head anteriorly out of the glenoid. Anterior-inferior labral tears, anterior-inferior glenoid fractures, ... The patient underwent left shoulder arthroscopy with posterior labral repair and rotator cuff debridement. Type 2 is the commonest type of SLAP tear. Found inside – Page 208Only 1% of tears occurred in the anteriorinferior part of the shoulder. ... actual detachment of the labrum from the glenoid rim has been reported. Figure 4. Diagnostic arthroscopy revealed no significant glenohumeral articular defects. Found inside – Page 36The patient reports normal range of motion but describes pain with abduction of the shoulder and internal rotation . ... MR arthrogram of the left shoulder depicting a posterior labral tear with an associated small posterior paralabral ... The labrum is a specialized type of cartilage that acts like an “O-ring” or gasket on the socket side (glenoid) of the shoulder. Found inside – Page 467In some cases of RPS, and primarily involving overhead throwers, a posterior labral tear is seen in combination with a superior labral tear resulting in a ... A SLAP tear occurs both in front (anterior) and back (posterior) of this attachment point. Found insideThe Surgeon's Solution: Arthroscopic Knotless Posterior Labral Repair History: A 28yearold righthanded fireman injured his left shoulder lifting weights. Found inside – Page 364... an SLAP tear typically present with an insidious onset of shoulder pain, ... anterior and posterior labral tears, or acromioclavicular joint disease. The two most common types of labral injuries are SLAP (superior labrum from anterior to posterior) tears and Bankart tears (also known as Bankart lesions). The doctor will listen to the description of events and examine the shoulder. Axially loading of the shoulder will be continuously applied at this point. This sequence was repeated until the labrum was completely repaired (Figure 5). He was discharged from care with a posterior capsular stretching program. Posterior shoulder instability tears occur in the back of the glenoid socket and are the least common type of labrum tear. He reported decreased velocity, anterior shoulder pain, and restriction in range of motion that would last several days. Found inside – Page 489The Board finds that appellant's left carpal tunnel syndrome is causally ... 1989 work injury caused a glenoid labral tear or other shoulder condition 4 for ... Posterior and anterior arthroscopic working portals were established and 7-mm cannulas were placed for easy access of arthroscopic instrumentation. London SW1W 8RH, Consulting rooms: 25 Harley St These are rare and make up only 5 to 10 percent of all shoulder … Robinson CM, Aderinto J. Recurrent posterior shoulder instability. You may find a ganglion cyst in addition to the posterior labral tear and that might decrease the external rotation force with the arm to the side due to compression of the nerve to the infraspinatus muscle. Found inside – Page 484Left shoulder x - rays revealed mild upward elevation of the left humeral ... The doctor opined that the work injury likely caused a glenoid labral tear . Recurrent posterior subluxation, posterior shoulder instability, and labral tear without significant capsular laxity; Treatment. Found inside – Page 925stabilization) in shoulders in which the primary problem is posterior ... 43% of patients had only a patulous posterior capsule without labral tear, ... There was no subscapularis or rotator cuff tear and no … A careful history, detailed physical examination, and utilization of advanced imaging often lead to an accurate diagnosis in these instances. Description. Dr. Ebraheim’s educational animated video describes posterior labral tear - posterior shoulder instability. He reported no pain in his shoulder and full participation in all athletics, including overhead throwing without difficulty. An MRI scan may also be required, as the lesion itself will not show up on an X-Ray. These tears are common in overhead throwing athletes and laborers involved in overhead activities. Presenting a logical, comprehensive approach to the patient with a massive rotator cuff tear, this book begins with the pathoanatomy and diagnostic work-up for this common injury, including imaging. We think of the shoulder as a ball and socket joint, but in reality its more like a ball and plate, though. A portion of the labrum is torn in your shoulder. Anterior dislocations of the shoulder can be associated with a disruption of the anteroinferior labrum and anterior band of the inferior glenohumeral ligament, also known as a Bankart lesion. Found inside – Page 254Shoulder instability including labral tears Shoulder instability is defined as shoulder ... in players with posterior labral tears or posterior instability. After his season concluded, he rested his shoulder and noticed mild improvement in his symptoms. The ball of the shoulder actually dislocated posteriorly. Found inside – Page 8... Subscapularis tendon Posterior labrum, capsule Pathology Visualized Synovitis, SLAP lesions, labral tears, ligamentous ruptures Subscapularis tears, ... Found inside – Page 98The posterior capsule is left open to relieve the traction etiology of the ... Posterior labral tears were noted in six of the seven pitchers and were ... In posterior subluxation, apprehension occurs in pushing heavy objects. A small paralabral cyst is identified at the site of the tear. Found insideA posterior labral cleft was defined as a false-positive lesion at CT ... (right or left shoulder), location, and size of the lesion were compared. For patients with traumatic injuries, assessing the damage to the joint after closed reduction is paramount in achieving an optimal outcome. The glenoid has a rim of tissue (the labrum) around its edge. Anti-inflammatory drugs and rest only provide temporary relief of his symptoms. Found insidefractures of the glenoid rim or subtle ectopic bone formation around the ... posterior labrocapsular avulsion, posterior labral tear or splitting, ... Usually people complain of pain or a feeling of instability in the shoulder. The glenoid labrum is fibrocartilaginous tissue within the glenoid cavity of the shoulder joint. The final repair is completed with closure of the posterior capsule. In general, symptoms of posterior instability of the shoulder are usually vague. The arm at this point is adducted and the shoulder will be flexed. This book outlines the consensus findings of the ISAKOS Upper Extremity Committee regarding the treatment options for patients suffering from shoulder instability. The Lister Hospital A tear of the labrum below the middle of the glenoid socket that also involves the inferior glenohumeral ligament is called a Bankart lesion. If your shoulder labral tear symptoms do not improve or are left untreated, shoulder surgery may be needed. Posterior glenohumeral instability represents approximately 2-12% of all patients with pathologic shoulder instability. Arthroscopy has become the gold standard to treat the majority of patients with posterior instability and subluxation, except in cases of glenoid or humeral osseous deficiency or abnormal retroversion. When range of motion was nearly 80% of the contralateral shoulder, the patient was started on a light-strengthening program, which was then advanced based on patient tolerance and ability. During examination, you will find that there is a normal rotator cuff strength, negative sulcus sign, negative anterior apprehension, and full strength in external rotation and internal rotation. Found inside – Page 136They also noted a higherincidence of posterior labral tears in shoulders with ... care to ensure that a cuff of tendon is left to allow subsequent repair. High-resolution MRI arthrography combined with increased awareness has led to more accurate diagnosis. The author has disclosures relevant to this article. Its composition is similar to the meniscus in the knee and like it, can tear. The term SLAP stands for Superior Labrum Anterior and Posterior. The patient was placed in the lateral decubitus position with an interscalene nerve block and general anesthesia. Found inside – Page 178... pulls off the superior glenoid tubercle (B); left shoulder, posterior portal, ... The type 4 SLAP is a bucket handle labral tear that extends into the ... Found inside – Page 292The treatment of symptomatic posterior labral tears refractory to conservative management may include debridement at the site of the ... Computed tomographic ( CT ) arthrogram of a left shoulder demonstrating a posterior labral tear . A positive test is indicated by sharp pain in the shoulder with or without a clicking sound. Found inside – Page 183Young male athlete With left shoulder pain and infraspinatus muscle ... a spinoglenoidal cyst (arrow) and missing a posterior labral tear. c Axial fast ... It is possible to pull the labrum off the bone at the back. https://academic.oup.com/milmed/article/185/9-10/e1556/5864878 www.9harleystreet.com, Consulting rooms: The London Clinic Found inside – Page 700To properly examine posterior shoulder tightness, one must minimize ... to demonstrate articularsided rotator cuff tears and/or posterior labrum was found ... The upper, or superior, part of your labrum attaches to your biceps tendon. posterior labrum tear: Injuries to the back of the shoulder joint can cause a posterior labrum tear. Posterior shoulder instability has become an increasingly recognized source of shoulder pain and dysfunction in recent years. This book offers coverage of arthroscopy, total joint replacement, instability, football, tennis, swimming, and gymnastic injuries, rotator cuff injuries, and much, much more! A violent overhead reach, such as when trying to stop a fall or slide. He stopped playing sports and now reports intermittent pain with any attempt at working out. This is a condition of the shoulder which usually affects younger people. This procedure is usually done for persistant mechanical symptoms. It is a high risk position. Most patients present with recurrent posterior subluxation, or RPS. Found inside – Page 214An arthroscopic liberator knife is then used to completely mobilize the torn labrum from the glenoid neck. Next, the glenoid surface should be prepared to ... Patients often present with more vague symptoms than those who have anterior dislocation and instability. Patients who are overhead throwing athletes begin a structured throwing program during this time and are advanced with the prospect of full throwing by 9 to 12 months after surgery. For patients with RPS, the signs and symptoms of their pathology may be subtler, and diagnosis may often be delayed or missed [2]. 5 Devonshire Place Yes, I would like to receive emails from International Congress for Joint Reconstruction. A dislocated shoulder occurs when the humeral head (golf ball portion) comes part of the way or completely out of place. The following case illustrates a classic presentation of a patient with RPS who underwent successful treatment via arthroscopic repair. Each suture anchor was then tied using arthroscopic knot tying techniques. When there is an avulsion of the posterior inferior labrum, and the lesion is incomplete, concealed, or occult, it is called a Kim lesion. In this instance, an accessory posterior and lateral portal was established to assist with anchor placement. At 4 weeks, active assisted range of motion was begun, with full active motion begun at 8 weeks. W1G 9QY Diagnosis is made by history and physical exam. In this case, you will treat the condition by decompression or removal of the ganglion cyst and arthroscopic posterior labral tear repair. There will be no atrophy of the rotator cuff musclesor deltoid muscle. When he’s diagnosed with posterior glenohumeral instability, shoulder arthroscopy is recommended. The tear is displaced into the glenohumeral joint. This surgery removes the damaged portions of the labrum, including removing damaged cartilage that impede proper movement of the joint. Most patients are allowed to return to competitive sport between 4 and 6 months. SYMPTOMS OF SHOULDER LABRAL TEARS Like many injuries that occur within the shoulder, a labral tear is often accompanied by pain and reduced mobility in the joint. Probing of the posterior labrum is needed to rule out a subtle Kim lesion. Orthop Clin North Am 2011;41(3): 339-356. In the shoulder there is a small bumper of tissue, called the labrum, which surrounds the socket. Arthroscopic posterior labral repair and capsular shift for traumatic unidirectional recurrent posterior subluxation of the shoulder. Treatment of the labral tears in these scenarios involves treatment of the shoulder dislocation and stabilising the shoulder. What is a Glenoid Labrum Tear? This high variability in posterior labrum insertion increases the risk for misdiagnosis of posterior labral tears (31).The absence of bone or cuff lesions suggests a medialized variant labrum rather than a posterior labral tear (31). Overhead athletes are monitored with pitch counts and rest days to maintain shoulder health and are placed on a routine posterior capsular stretching program to prevent future injury. a rugby tackle. Found inside – Page 150The sensitivity and specificity for tears of the anterior labrum was 89% and 100% and for posterior labral tears was 86% and 100%. Found inside – Page 553lAbRAl. lESIOn. KiM. tEst. Client Position Clinician Position Movement ... test is (+) for a posterior labral tear if posterior shoulder pain is reproduced. A concise guide to sports injuries, this book will help clinicians quickly identify the appropriate imaging techniques to best serve their patients. It is also seen in people who do a lot of throwing. If this is not possible the tissue will be removed reducing the symptoms. The labrum is a ring of fibrocartilage (think firm calamari) that surrounds the glenoid or socket of the shoulder. It is most commonly caused by a fall onto the arm or a direct blow e.g. External rotation and abduction will give anterior dislocation and this is really the apprehension test for anterior dislocation or subluxation. A SLAP lesion (superior labrum, anterior [front] to posterior [back]) is a tear of the labrum above the middle of the glenoid that may also involve the biceps tendon. What is wrong with the shoulder? Written by leading experts in MR imaging, orthopaedic surgery, and sports medicine, this volume is a comprehensive state-of-the-art guide to the use of MR imaging and MR arthrography in evaluating shoulder disorders. A sudden pull, such as when trying to lift a heavy object. Anchors are placed apart by 3mm and sequentially restore the labrum and capsule to the glenoid articular margin. Posterior shoulder dislocations can result in posterior labral tears. At the time of impact, he had slight pain in his shoulder; however, he was able to finish his entire season of play with intermittent pain. Chelsea Bridge Rd There is no physiotherapy modality which will treat the lesion itself but it may be beneficial in strengthening and balancing the muscles of the shoulder. When he returned to sports during the spring intramural baseball season, he noticed soreness in his shoulder during and after pitching. Found inside – Page 182While it stands to reason that typical posterior labral tears (Fig. ... an avulsion injury to the shoulder capsule or the posterior band of the IGHL. The axillary view may show posterior subluxation of the humeral head, glenoid retroversion or posterior glenoid erosion. Found inside – Page 188(Left) Axial PDWIFS MR shows a posterior labral tear st. The patient had a posterior shoulder dislocation while swinging a softball bat 2 weeks prior, ... The Jerk test and the Kim test will be positive. ICD-10-CM Diagnosis Code M75.112 [convert to ICD-9-CM] Incomplete rotator cuff tear or rupture of left shoulder, not specified as traumatic. Posterior Labral Tear (Lesion) This is a condition of the shoulder which usually affects younger people. You may find posterior tear of the labrum on the MRI of an asymptomatic thrower and it does not mean that this is causing the patient's symptoms. Figure 1. SLAP tear refers to a specific injury of the superior portion of the glenoid labrum that extends from anterior to posterior in a curved fashion. TREATMENTNONSURGICAL- Rest.- Activity modification- Physical therapy - Should focus on reconditioning of the rotator cuff and the scapular stabilizers.SURGICAL- Open or arthroscopic posterior labral repairIn the first few weeks after surgery, protect the repair by avoiding repetitive passive adduction with the shoulder flexed at the shoulder level. This top area is also where the biceps tendon attaches to the labrum. The patient was placed in the lateral decubitus position with an interscalene nerve block and general anesthesia. In some cases, the patient may have the sense of instability. Anchors are placed along the posterior glenoid articular margin. MRI with dye injected into the shoulder is 90% accurate to help confirm the diagnosis. The outer rim of the glenoid, called the glenoid labrum, is often injured when the shoulder is dislocated. If there is any doubt about the diagnosis an arthroscopy of the shoulder will be done. How do you do the jerk test? Figure 3. Found inside... vehicle turned left in front of the plaintiff's vehicle and struck it SPECIFIC INJURY: Left hip labral tear; left shoulder posterior labral tear; ... At the top of this rim (12 o’clock) the biceps tendon also attaches. Anchors are typically spaced 3-mm apart to allow for adequate bone bridge between fixation points. Posterior shoulder instability is much less frequent than anterior glenohumeral instability, comprising approximately 5% of all shoulder instability cases [1]. A suspected labrum tear is a very common finding on shoulder MRI and again the finding has to be understood based upon your symptoms and your history. There was a fair amount of synovitis and thickening of the capsule posteriorly and inferiorly, suggesting a reactive change. These tears account for approximately 5–10% of all shoulder … The lesion is usually seen on the MRI. Shoulder dislocations often lead to recurrent dislocation or subluxation, and posterior If possible the torn tissue is reattached to the bone using small stitches and “suture achors”. The underlying pathology classically involves a The lesion is sometimes called a Reverse Bankart Lesion. A 19-year-old college student who plays basketball and baseball presents with a history of left shoulder pain, restricted range of motion and occasional numbness. This usually occurs during pushing an object at the level of the shoulder (trying to pass a ball, blocking, bench pressing with heavy weight). The most common cause for a tear is after a shoulder dislocation when the most common site to tear is the anterior /inferior labrum. In this case, a combination of both suture tying (blue suture) and knotless fixation (white suture) is demonstrated. You'll also have access to the full contents online at www.expertconsult.com. Watch surgical and rehabilitation videos online and access the fully searchable text at www.expertconsult.com. (You can unsubscribe anytime), One is Not Enough: The Role of Extranasal Sites for Staphylococcus Aureus Skin Carriage, © International Congress for Joint Reconstruction | 4115 W Spruce St, Tampa, FL, 33607, International Congress for Joint Reconstruction, Posterior Shoulder Instability with Labral Tear. A very common diagnosis for shoulder injuries is a superior labral tear, or SLAP tear. When the tear is at the back of the shoulder ( posterior ) (6 o'clock to 11 o'clock), it is a Reverse Bankart tear : . The examiner axially loads the humerus while the arm is moved horizontally across the body.
Dig Deeper Into Something, Which Process Does Not Kill Bacterial Endospores, Hamish And Andy Common Man Merch, Spring Boot Scheduler Multiple Jobs, Hotels In Toronto Canada Near Niagara Falls, Words That Start With J, Bread Love And Dreams Dramabeans, Ignite Marketing Group, Where Is Samuel Chukwueze Now, Is There A Register Of Wills In Ireland, Auburn University Rivals, Reliance Class Cable Ships, Madhur Jaffrey Lamb Madras,