Type 2 SLAP Tear in 22 Year Old Male with Associated Buford Complex Treated with SLAP Repair with Care to Avoid Overconstraining Anteriorly

Abstract

Normal anatomic variants of the anterosuperior labrum are common and include the sublabral foramen and the Buford complex. The Buford complex is a rare variant found in a subset of patients with absent anterior-superior labral tissue and a “cordlike” middle glenohumeral ligament (MGHL) originating directly from the superior labrum at the base of the biceps tendon (Williams, Snyder, Buford Jr. Arthroscopy 10:241–7, 1994). The incidence of the Buford complex varies between 1.5% and 6% (Williams, Snyder, Buford Jr. Arthroscopy 10:241–7, 1994; Ide, Maeda, Takagi. Arthroscopy 20:164–8, 2004; Ilahi, Labbe, Cosculluela. Arthroscopy 18:882–6, 2002). A sublabral foramen variant may also be present with or without a “cordlike” middle glenohumeral ligament. When present, the Buford complex is typically associated with an absent superior glenohumeral ligament and a well-developed inferior glenohumeral ligament. Furthermore, this variant may predispose patients to possible superior labral injury (Bents, Skeete. J Shoulder Elb Surg 14:565–9, 2005; Rao, Kim, Chronopoulos, McFarland. J Bone Joint Surg Am 85-A:653–9, 2003).