SUPERIOR LABRUM BICEPS TENDON COMPLEX LESIONS OF THE SHOULDER

The detachment of the superior labrum from anterior to posterior has p reviously been reported, This lesion has been classified into four typ es. It was our impression that not all superior labrum abnormalities f it into such a classification system and that the mechanism of injury was distinctly different. During a 5-year period, 84 of 712 (11.8%) pa tients had significant labral abnormalities; 52 of 84 patients (6.2%) had lesions that fit within the classification system (Type II, 55%; I II 4%; IV, 4%), but 32 of 84 patients (38%) had significant findings t hat could not be classified. These unclassifiable lesions fit into thr ee distinct categories. Two of three patients described a traction inj ury to the shoulder. Only 8% sustained a fall on an outstretched arm; 75% had a preoperative diagnosis of impingement based on consistent hi story and provocative testing; however, when examined under anesthesia , 43% of the shoulders were considered to have increased humeral head translation when compared with the other shoulder. Recognition of supe rior labrum-biceps tendon detachment should prompt the surgeon to inve stigate glenohumeral instability as the source of a patient's complain ts.