title: Successful Nonoperative Management of HAGL (Humeral Avulsion of Glenohumeral Ligament) Lesion With Concurrent Axillary Nerve Injury in an Active-Duty US Navy SEAL.
abstract: Humeral avulsion of the glenohumeral ligament (HAGL) is a lesion that has been recognized as a cause of recurrent shoulder instability. To our knowledge there are no reports of successful return to full function in young, competitive athletes or return to manual labor following nonoperative management of a HAGL lesion. A 26-year-old Navy SEAL was diagnosed with a HAGL injury, and associated traction injury of the axillary nerve as well as a partial tear of the rotator cuff. Operative intervention was recommended; however, due to issues with training and with inability to properly rehab with the axillary nerve injury, surgical plans were delayed. Interestingly, the patient demonstrated both clinical and radiographic magnetic resonance imaging healing of his lesion over an 18-month period. At 18 months the patient had returned to full active duty without pain or instability as a Navy SEAL.
authors.affiliation: Department of Orthopedic Surgery, Tripler Army Medical Center, Honolulu, HI. justin.ernat@gmail.com.
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Ernat
authors.forename: Craig R
authors.initials: CR
authors.lastname: Bottoni
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Rowles
mesh_terms: D000328:Adult; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000503:physiopathology; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000534:rehabilitation*; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology; D008297:Male; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular / Q000502:physiology; D000070599:Shoulder Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000534:rehabilitation*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016896:Treatment Outcome