Alpsa lesion

Alpsa lesion, shoulder arthroscopy, educational ppt, future references, shoulder made easy

1. By Dr. Prakhar Chhawchharia Orthopaedic Surgeon MBBS, D(Ortho) Mch (Ortho) Fellowship in Arthroscopy ALPSA LESION

2. INTRODUCTION ALPSA - A NTERIOR L ABRO-LIGAMENTOUS P ERIOSTEAL S LEEVE A VULSION INJURY Type of Gleno - humeral instability. TUBE- Traumatic Anterior Unidirectional Bankart lesion requiring Surgery Can be called medialized Bankart INCIDENCE is 1.7% in general population with 80% injury in teenagers

3. SURGICAL ANATOMY IGHL- 90 ABD ER MGHL- ABD ER SGHL AT REST/LIMB BY SIDE STATIC RESTRAINTS

4. MECHANISM OF INJURY

5. PATHOPHYSIOLOGY

6. PATHOPHYSIOLOGY ANTERO-INFERIOR LABRUM GETS AVULSED WITH THE PERIOSTEAL SLEEVE OF THE GLENOID THE LABRUM+LIGAMENT+PERIOSTEUM COMPLEX GETS ROTATED INTERNALLY DISPLACED MEDIALLY AND FALLS BEHIND THE GLENOID

7. CLINICAL FEATURES ACUTE AND RECURRENT DISLOCATION FEELING OF INSTABILITY SHOULDER PAIN CLINICAL TESTS APPREHENSION SIGN-90/90 POSITION -SUPINE RELOCATION TEST -SUPINE SULCUS SIGN -SITTING

8. INVESTIGATIONS CLINICAL EXAMINATION XRAY – WEST POINT VIEW- GLENOID BONE LOSS - STRYKER VIEW - HILL SACH’S LESION MRI PREFERABLY WITH CONTRAST

9. TREATMENT OPERATIVE ARTRHOSCOPIC LABRAL REPAIR WITH CAPSULAR REPAIR REPAIR OF HILL SACHS’S OR ENGAGING HILL SACH’S LESION

10. *STRIVE TO BE THE HARDEST WORKER IN THE ROOM*