Mini-open repair technique of HAGL (humeral avulsion of the glenohumeral ligament) lesion.
This article describes a limited open technique to repair humeral avulsions of the glenohumeral ligament (HAGL). The main feature of this technique is the sparing of the superior 50% of the subscapularis tendon. Essentially, an L-type incision is made in the lower third of the subscapularis tendon approximately 1 cm medial to the lesser tuberosity. The transverse limb of this incision is made just superior to the anterior circumflex vessels. Beginning inferiorly, the subscapularis tendon is lifted up, exposing the humeral ligament avulsion. The HAGL lesion is then repaired with 2 or 3 suture anchors anatomically. The advantages of this technique are preservation of the important superior tendinous portion of the subscapularis tendon, thereby preserving strength, easier rehabilitation, and return to full activity.