A Buford Complex in a Division I Collegiate American Football Player

in International Journal of Athletic Therapy and Training
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A 19-year-old African-American male Division I collegiate American football player with no prior history of shoulder injury presented with right shoulder pain after making a tackle during a game. He was initially diagnosed with a rotator cuff strain with potential underlying labral pathology. Subsequent magnetic resonance imaging arthrogram showed no labral tearing, though a Buford complex was identified. A Buford complex is a normal anatomical labral variant where the anterior labrum is absent and the middle glenohumeral ligament is “cord-like” in structure. This case was managed conservatively since surgical intervention is only recommended if there is a secondary pathology to the shoulder (e.g., type II superior labrum anterior to posterior [SLAP] lesions). Clinicians should be aware of Buford complexes because they can predispose athletes to secondary injuries and can be managed successfully with a conservative rehabilitation approach in the absence of secondary pathology.

Wiese and Godoy are with the Department of Athletics, Central Michigan University, Mt. Pleasant, MI, USA. Miller is with the School of Rehabilitation and Medical Sciences, Central Michigan University, Mt. Pleasant, MI, USA.

Wiese (brian.wiese@cmich.edu) is corresponding author.
  • 1.

    Williams MM, Snyder SJ, Buford D Jr. The Buford complex—the “cordlike” middle glenohumeral ligament and absent anterospuerior labrum complex: a normal anatomical capsulolabral variant. Arthroscopy. 1994;10:241247. PubMed ID: 8086014 doi:10.1016/S0749-8063(05)80105-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Kanatli U, Ozturk BY, Bolukbasi S. Anatomical variations of the anteriosuperior labrum: prevalence and association with type II superior labrum anterior-posterior (SLAP) lesions. J Shoulder Elbow Surg. 2010;19:11991203. PubMed ID: 21070956 doi:10.1016/j.jse.2010.07.016

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Ilahi OA, Labbe MR, Cosculluela P. Variants of the anterosuperior glenoid labrum and associated pathology. Arthroscopy. 2002;18:882886. doi:10.1053/jars.2002.36119

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Rao AG, Kim TK, Chronopoulos E, McFarland EG. Anatomical variants in the anterosuperior aspect of the glenoid labrum: a statistical analysis of seventy-three cases. J Bone Joint Surg Am. 2003;85:653659. PubMed ID: 12672841 doi:10.2106/00004623-200304000-00011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Bents RT, Skeete KD. The correlation of the Buford complex and SLAP lesions. J Shoulder Elbow Surg. 2005;14:565569. PubMed ID: 16337521 doi:10.1016/j.jse.2005.01.002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Snyder SJ, Karzel RP, Del Pizzo W. SLAP lesions of the shoulder. Arthroscopy. 1990;6:274279. PubMed ID: 2264894 doi:10.1016/0749-8063(90)90056-J

  • 7.

    Aydin N, Sirin E, Arya A. Superior labrum anterior to posterior lesions of the shoulder: diagnosis and arthroscopic management. World J Orthop. 2014;5(3):344350. PubMed ID: 25035838 doi:10.5312/wjo.v5.i3.344

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Popp D, Schöffl V. Superior labral anterior posterior lesions of the shoulder: current diagnostic and therapeutic standards. World J Orthop. 2015;6(9):660671. PubMed ID: 26495243 doi:10.5312/wjo.v6.i9.660

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy. 2003;19:404420. PubMed ID: 12671624 doi:10.1053/jars.2003.50128

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Tuite MJ, Orwin JF. Anterosuperior labral variations of the shoulder: Appearance on gradient-recalled-echo and fast spinecho MRI images. Radiology. 1996;199:537540. PubMed ID: 8668808 doi:10.1148/radiology.199.2.8668808

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Tuite MJ, Blackenbaker DG, Seifert M. Sublabral foramen and buford complex: inferior extent of the unattached or absent labrum in 50 patients. Radiology. 2002;223:137142. PubMed ID: 11930058 doi:10.1148/radiol.2231010896

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Shortt CP, Morrison WB, Shah SH, Zoga AC, Carrino JA. Association of glenoid morphology and anterosuperior labral variation. J Comput Assist Tomogr. 2009;33:584586. PubMed ID: 19638855 doi:10.1097/RCT.0b013e31818da69d

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Crockett HC, Wingert NC, Wright JM. Repair of SLAP lesions associated with a buford complex: a novel surgical technique. Arthroscopy. 2011;27:314321. PubMed ID: 21126845 doi:10.1016/j.arthro.2010.09.005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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