Abstract
Aim: To study the morphology of the anterior cap-suloligamentous structures of the glenohumeral joint. Methods: Eighty non-embalmed cadaver shoulders were studied. Twenty shoulders were dissected through an anterior approach, twenty through a posterior approach. In another twenty shoulders the anteroinferior capsuloligamentous complex was examined arthroscopically through a posterior portal. In all of these sixty shoulders the functional anatomy was studied by moving the arm from its resting position along the body to maximal abduction and external rotation. Dissecting another twenty shoulders through an inferior approach completed the study of the humeral insertion of the inferior glenohumeral ligament. Results: The inferior, middle and superior glenohumeral ligament are usually only discernible by palpation, but not visually. When the capsule is ßattened out, these ligaments can no longer be discriminated macroscopically. The classic Z-like structure can be seen when examining the anterior capsule from its posterior side, but only when the shoulder is at rest, which is with the arm along the body. The functional study shows that this Z corresponds with a folding phenomenon of the capsuloligamentous ÒpouchÒ to accommodate the relative excess of length when the arm is at rest. A progressive unfolding occurs as the arm is progressively abducted and externally rotated. By creating a functional shortening, the folding mechanism provides pretensioning of the ligaments. Conclusion: At the anteroinferior part of the shoulder joint, there is a real, functional capsuloligamentous unit.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
