Tuesday, May 1, 2012

SLAP Tears (Superior Labrum Anterior-Posterior Tears)


What is the Labrum?
The labrum is located on the anterior and posterior part of the inner shoulder. The labrum acts like a washer, which is wrapped tightly around the humorous glenoid, which then fits nice and snug within the shoulder socket. The labrum keeps the ball of the humorous from grinding up against the socket itself.

Type 1
A type one-slap tear is very common; it’s basically a degeneration of the labrum over time. When the labrum is starts to fray, it looks very similar to a piece of yarn that is frayed. Most of the time there is no pain that occurs. Some inflammation may occur which can be cured with a simple cortisone shot. Most of the time the individual does not suffer from any particular symptoms.

Type 2
In the world of baseball, a type two-slap tear is one of the most common injuries, which occur mostly in pitchers. This kind of slap tear can come from a dislocation or even overuse. A type two-slap tear is when a part of the labrum is slightly torn from the glenoid. There is often clear space between the labrum and the glenoid, which on an MRI will show up as blue where the dye has settled. Type two-slap tear can characterized as posterior or anterior. Most of the pain occurs from the glenoid grinding up against bones in the shoulder socket. This injury can be cured with simple physical therapy to strengthen the posterior shoulder but often results in surgery.

Type 3
A bucket Handle also known as a type three-slap tear of the labrum is where the top portion of the labrum is torn off the gleniod and hangs down in the socket; this often causes the should to pop out as well as a chunky feeling within the shoulder when rotating. Orthoscopic surgery is required where the torn labrum is actually removed and sutures are used to lock down the loose ends of the labrum.

Type 4
A type four-slap tear is the worst kind of labrum injury. This severe injury is similar to a type three-slap tear and also involves the tearing of the upper half of the bicep tendon as well.  Orthoscopic surgery is used to anchor the loose tendons down to the glenoid.

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