TY - JOUR T1 - Combined Posterior Osseous Bankart Lesion and Posterior Humeral Avulsion of the Glenohumeral LigamentsA Case Report and Pathoanatomic Subtyping of “Floating” Posterior Inferior Glenohumeral Ligament Lesions AU - Ames, James B. AU - Millett, Peter J. Y1 - 2011/10/19 N1 - 10.2106/JBJS.K.00010 JO - The Journal of Bone & Joint Surgery SP - e118 1 EP - 4 VL - 93 IS - 20 N2 - The pathoanatomy of anterior shoulder dislocations has been well documented. Perthes1 described an anterior labral lesion as early as 1906, and Bankart2 wrote his classic article on recurrent anterior dislocations more than seventy years ago. Until recently, much less had been written about posterior shoulder instability; to our knowledge, the first case series was reported by Reeves3 in 1963. Recurrent posterior glenohumeral joint instability is far less common than anterior instability, accounting for approximately 2% to 10% of all cases of shoulder instability4. Pathoanatomic findings in patients with unidirectional posterior instability include a posterior Bankart lesion, posterior humeral avulsion of the glenohumeral ligament (PHAGL), and various combinations of the two5,6. In their article on humeral avulsion of the glenohumeral ligament (HAGL), Bui-Mansfield et al.7 defined the floating posterior inferior glenohumeral ligament (floating PIGHL) as a combined posterior Bankart lesion and PHAGL. Multiple cases of this lesion have been reported in the literature7-11. To our knowledge, there has been no reported case of the specific combination of a posterior osseous Bankart lesion and a PHAGL injury. We present a case of recurrent posterior instability associated with a combined PHAGL injury and posterior osseous Bankart lesion. We also describe four pathoanatomic subtypes of floating PIGHL lesions. The patient was informed that data concerning his case would be submitted for publication, and he provided consent. SN - 0021-9355 M3 - doi: 10.2106/JBJS.K.00010 UR - http://dx.doi.org/10.2106/JBJS.K.00010 ER -