Werner A, Mueller T, Boehm D, Gohlke F
Department of Orthopedics, University of Wuerzburg, Germany.
Am J Sports Med. 2000 Jan-Feb;28(1):28-31. doi: 10.1177/03635465000280011701.
A histoanatomic study of the rotator cuff interval was done in 13 cadaveric specimens to investigate the relation of its ligamentous structures to the long head of the biceps tendon, with a special focus on revealing a stabilizing function. After macroscopic evaluation, the lateral half of the rotator cuff interval capsule was cut into three sections: medial, middle, and lateral. These sections were embedded in methacrylate, and then serial sections were made and stained for polarized light microscopy. The superior glenohumeral ligament was seen to form a fold having the macroscopic appearance of a U-shaped anterior suspension sling for the long head of the biceps tendon. Microscopic evaluation revealed an important role of the fasciculus obliquus in the roof of this sling. Fibers of the supraspinatus tendon join the posterosuperior part of the sling. The subscapularis tendon is not involved in this suspensory mechanism. As a result of these observations, we determined that the superior glenohumeral ligament and the fasciculus obliquus are the most important ligamentous reinforcements of a stabilizing sling for the long head of the biceps tendon in the rotator cuff interval. Their histologic appearance indicates they function to protect the long head of the biceps against anterior shearing stress. A lesion of this sling might lead to anterior instability of the biceps tendon.
对13个尸体标本进行了肩袖间隙的组织解剖学研究，以探讨其韧带结构与肱二头肌长头肌腱的关系，特别关注揭示其稳定功能。经过宏观评估后，将肩袖间隙囊的外侧半部分切成三段：内侧、中间和外侧。将这些切片包埋在甲基丙烯酸酯中，然后制作连续切片并进行偏振光显微镜染色。可见肩胛上盂肱韧带形成一个褶皱，在宏观上呈现为肱二头肌长头肌腱的U形前悬吊索。显微镜评估显示斜束在该悬吊索顶部起重要作用。冈上肌腱纤维连接到悬吊索的后上部。肩胛下肌腱不参与这种悬吊机制。基于这些观察结果，我们确定肩胛上盂肱韧带和斜束是肩袖间隙中肱二头肌长头肌腱稳定悬吊索最重要的韧带加强结构。它们的组织学外观表明它们的功能是保护肱二头肌长头免受前向剪切应力。该悬吊索的损伤可能导致肱二头肌肌腱的前向不稳定。
