Sugalski Matthew T, Wiater J Michael, Levine William N, Bigliani Louis U
The Shoulder Service, New York Orthopaedic Hospital, New York, NY 10032, USA.
J Shoulder Elbow Surg. 2005 Jan-Feb;14(1):91-5. doi: 10.1016/j.jse.2004.04.014.
To define inferior humeral capsular anatomy better, 12 cadaveric shoulders were dissected and an inferior capsular shift was performed. Two types of inferior humeral attachments were identified. In 7 specimens, the anterior capsular insertion bifurcated at the 8-o'clock position (on a right specimen) into a superior internal fold adjacent to the articular cartilage and an inferior external fold on the humeral surgical neck. In 5 specimens, the capsular insertion did not split but inserted over a broad area on the surgical neck. In all specimens, there was a re-confluence of the two folds at the 4-o'clock position. The inferior humeral capsular attachment may extend as far as 2 cm inferior to the articular surface and can be divided into two distinct types, split and broad, each with distinct internal and external folds of the capsule. Failure to release both of these folds limits the ability to shift the capsule superiorly by tethering the capsule inferiorly.
为了更好地界定肱骨头下关节囊的解剖结构，对12具尸体肩部进行了解剖，并进行了关节囊下移位操作。确定了两种类型的肱骨头下附着。在7个标本中，前关节囊插入点在（右侧标本的）8点钟位置分叉，形成一个与关节软骨相邻的上内侧皱襞和一个位于肱骨外科颈的下外侧皱襞。在5个标本中，关节囊插入点未分开，而是在外科颈的一个较宽区域插入。在所有标本中，这两个皱襞在4点钟位置重新汇合。肱骨头下关节囊附着可能延伸至关节面下方2厘米处，可分为两种不同类型，即裂开型和宽阔型，每种类型都有独特的关节囊内、外侧皱襞。未能松解这两个皱襞会通过将关节囊向下束缚而限制其向上移位的能力。
