[SLAP Injuries - Superior Labrum Anterior Posterior.].
From May to December 1996 the author treated at his Clinic five patients with injuries of the anchoring of the labrum superior and anchoring of the long head of the biceps. Snyder describes these injuries as SLAP -superior labrum anterior posterior. Only the development of arthroscopic technique provided new findings on these lesions. Anamnestic data and the clinical picture closely resemble the impingement syndrome. Here too irritation of the rotator cuff occurs but the cause is intraarticular. Theoretical work provides evidence that injuries of this type lead to reduction of the torsion rigidity of the shoulder joint reduced tension of the lower glenohumeral ligament. This along with chronic overburdening by so-called overhead activity creates prerequisites for the development of microinstability of the shoulder. This is why acromioplasty does not lead to improvement. As regards treatment a conservative procedure focused on correct conditioning of the brachial plexus dominates (in particular of the stabilizers of the scapula), administration of non-steroid anti-inflammatory drugs (NSAID), intraarticular corticoid administration, physical therapy, surgery is the last method of choice. Depending on the type of lesion it is recommended to treat the labrum superior and the tendon of the biceps, and depending on the degree of instability, the operation is supplemented by stabilization. Debridement of the rotator cuff is not always necessary, acromioplasty is performed when the acromion has shape II or III. The presented results are preliminary. In the first three patients the condition improved and at present they pursue sports as formerly. Another two patients still have rehabilitation treatment. Key words: SLAP lesion, superior labrum anterior posterior, microinstability, surgery of SLAP, arthroscopy, stabilization surgery and acromioplasty in the treatment of SLAP lesions.
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Ortopedická klinika IPVZ, Praha-Bulovka.