Persistent pain after distal claviculectomy (the Mumford procedure) has been attributed to both inadequate and excessive clavicle resection or incomplete supraspinatus outlet decompression with continued impingement. A retrospective review of twenty glenohumeral arthroscopies done in shoulders with a previous Mumford procedure disclosed 15 cases, (75%) of superior glenoid labrum, long head biceps tendon (SLAP) lesions. Most of the distal calvicle resections 13 out of 15 (86%) had been done for "acromioclavicular arthritis." These patients were young, with an average age of 37 years (range 20 to 50) and most, 14 out of 15, had pain attributable to a specific traumatic event. Most had deep pain referable to the bicipital groove with cross chest adduction of the shoulder with the elbow extended and forearm pronated (thumb down). The discomfort improved with the forearm supinated (thumb up). It is concluded the SLAP lesion to be part of the differential diagnosis of acromioclavicular joint disease. In younger patients with a traumatic history, glenohumeral arthroscopy should be used to rule out SLAP pathology and possibly prevent an unnecessary distal clavicle resection.





Polls results
1

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change
BIG change
93% Article relates to my practice (14/15)
6% Article does not relate to my practice (1/15)
0% Undecided (0/15)
2

Will this article lead to more cost-effective healthcare?

73% Yes (11/15)
26% No (4/15)
0% Undecided (0/15)
3

Was this article biased? (commercial or personal)

0% Yes (0/15)
86% No (13/15)
13% Undecided (2/15)
4

What level of evidence do you think this article is?

6% Level 1 (1/15)
26% Level 2 (4/15)
46% Level 3 (7/15)
20% Level 4 (3/15)
0% Level 5 (0/15)