Anterior labroligamentous periosteal sleeve avulsion lesion
An anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion is similar to a Bankart lesion, in that it too is usually due to anterior shoulder dislocation and involves the anterior inferior labrum.
Unlike the Bankart lesion in which the labrum and glenoid periosteum is avulsed from the underlying glenoid, an ALPSA lesion involves mobilisation of the labrum which remains attached to the periosteum overlying the glenoid (thus sleeve). As a result, an ALPSA lesion may heal (as opposed to a Bankart lesion which does not), however it can do so in an abnormal position requiring identification and early surgical repair. The clue to identifying an ALPSA lesion is the medial displacement and inferior shifting of the inferior glenohumeral ligament (IGHL) complex. A Hill-Sachs lesion may be seen in association.
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