Slap Injury and Repair

Slap Injury and Repair
July 4, 2016

spal-injuryDr. Gupta contemplates about SLAP injury and says, “SLAP injury is an injury caused to the upper end of the labrum by either a fall on the outstretched hand, direct blow to the shoulder, shoulder dislocation or repeated overhead activities of the arm.” Asserting the importance of labrum in functioning of the shoulder, Dr. Gupta reasons that, “Labrum is the ring of cartilage that surrounds the glenoid in which the upper arm bone fits. It stabilizes the shoulder joint and is the point which becomes an attachment port for the bicep tendon and many ligaments arising out of the shoulder.”

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Dr. Gupta needs no introduction in the field of upper extremity as his 25 years of experience and more than 6000 surgeries are enough to mark his credibility. AIIMS, Fortis, Medanta-The Medicity  and at present Max Healthcare have been his forte of delivering selfless service to patients affected by debilitating conditions of upper extremities.

Coming back to SLAP injury he states, “ These injuries result in intense pain and more so after strenuous overhead activities of the arm along with catching and clicking sound while moving the shoulder. I would rather say that mobility of the shoulder also becomes difficult and it is grasped by sudden weakness and instability.”

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With belief in delivering painless surgical techniques to each patient and being known as a hand and shoulder specialist Dr. Gupta firmly adheres to compassionate rehabilitation for minor patients who are attacked by congenital diseases. He is the most skilled hand in the field with a calm demeanor and ever too smiling ability that instantly puts his patients at ease.

“SLAP injuries are best treated by surgical techniques as they are successful in rejuvenating the mobility of the shoulder to 80% even though we try and begin with non surgical techniques that comprise of medications and therapy exercises. For surgical techniques we use arthroscopic repair as the most prevalent technique.”

Summing up his conclusions on SLAP injury he asserts, “Labrum normally wears down after 40 so sometimes people are affected by labrum tears because of this. Medical alertness is essential for patients after 40 years of age and I would advise patients to seek medical assistance from a skilled specialist for complete healing.”


FAQ – Slap Injury and Repair

An injury to the top portion of the labrum of the shoulder that extends to both front and the back side is termed as SLAP (Superior Labral Anterior to Posterior) injury or tear.
The shoulder joint comprises of three bones i.e. the humerus, scapula and the clavicle. The humerus i.e. the upper arm bone firmly fits into a rounded socket at the shoulder blade known as glenoid. The strong, fibrous ring of cartilage that surrounds the glenoid is the labrum.
The labrum acts as a stabilizer for the shoulder joint by deepening the socket of the glenoid and a port through which many ligaments as well as tendon from the bicep muscle in the arm attach themselves to the shoulder.
The upper end of the labrum has inadequate supply of blood thereby making it prone to easy injury. The main causes that contribute to it are a traumatic fall on the outstretched hand, direct blow sustained by the shoulder, repetitive overhead movements like in throwing sports or shoulder dislocations. Sometimes SLAP tear is also observed in people above 40 years of age because of normal wearing down of labrum which is correlated to ageing.
The symptoms of SLAP injury are not much different than many other debilitating conditions of the shoulder. Among such the most significant sign is a deep, intense and constant pain in and around the shoulder, more so after a repetitive overhead activity. The shoulder feels weak and unstable while moving and can result in a clicking or catching sound. The shoulder may lose its mobility and strength gradually.
After complete medical and physical examination, to further the prognosis the doctor recommends imaging tests like X-Ray, MRI scan.
There are very few cases of SLAP injury that are not accompanied by other injuries, hence they need to be treated accordingly. Initial treatment of SLAP injury begins with anti inflammatory medicines with therapy exercises. Further treatment of SLAP injury if not relieved includes surgical techniques such as:

Arthroscopy surgery: after making 2 to 3 small incisions in the shoulder the repair of the labrum tear is done which brings back mobility in the shoulder.

Debridement of the SLAP tear: the loose labrum is smoothed and repaired.

Arthroscopic Tenodesis of the biceps tendon: Under this technique the tendon is cut away from the labrum and reattached to the humerus. It is practiced in sever unstable SLAP injuries.
The success ratio of surgery in SLAP injury is usually more than 80%.
There are various probable complications that can arise after surgery. Common complications that can occur are infection in the wound, failure of surgery in providing relief or damage to any nerve or blood vessel.
It is essential to keep the shoulder protected after surgery for sometime as the repaired labrum is weak and follow thereafter by therapy exercises. The wound should also be kept dry and clean so that it is not affected by infection. Any other advise or prescribed activities by the doctor, should be diligently followed.
Some sport activities would be prohibited for at least three months and other contact sports are not allowed before 4-6 months depending on the repair of the labrum. Driving should be abstained for about a period of 6-8 weeks whereas normal desk work and mild activities can be resumed after 4 weeks or so.
Posted in Condition & Treatments by admin