Normal anatomy final
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Transcript of Normal anatomy final
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Christopher M. Aland MD
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DisclaimerI own stock in Arthrocare and Johnson and
JohnsonI have no conflicts that inhibit my ability to
teach this course
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Just a word about portals
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Marine Corps SloganNo better friend…no worse enemy
Sulla, Rome 73BC Mattis, Fallujah 2004
Aland, AANA, Chicago 2011
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Initial Viewing From Posterior:
Subscapularis tendon
MGHLIGHLSubscap insertionSGHL
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From Posterior, looking up:Biceps TendonHiatusElbow?Subluxed tendonOrigin on Glenoid
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Superior labrumAnterior labrumArticular surface
glenoidArticular surface
humeral headInferior labrum
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Inferior recessBare AreaUndersurface cuff
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From AnteriorPosterior superior
andPosterior labrumPosterior capsuleAnterior labrumSubscapularis recess
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Finish the job, look in the backUse two switching
sticksReorient selfProceed with exam
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Videos
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What not to fixBuford Complex:
Cordlike MGHL with no labrum beneath
Initially described in 1994, 10% incidence Buford et. Al
Increased incidence of SLAP tears noted Snyder 2003
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Don’t fix this eitherSublabral foramen
Common variant10-15% or moreDegenerative?Easy to put an
anchor hereDon’t