Clark J M, Harryman D T
Adult Reconstruction Service, University of Washington School of Medicine, Seattle.
J Bone Joint Surg Am. 1992 Jun;74(5):713-25.
We investigated the structure of the myotendinous rotator cuff in thirty-two grossly intact cuffs from thirty fresh cadavera of subjects who had been seventeen to seventy-two years old at the time of death. We studied the gross anatomy of the capsule and ligaments of the cuff, as well as histological sections of the tendons of the subscapularis, supraspinatus, and infraspinatus muscles. The tendons were found to splay out and interdigitate to form a common, continuous insertion on the humerus. The biceps tendon was ensheathed by interwoven fibers derived from the subscapularis and supraspinatus tendons. The anterior margin and bursal surface of the supraspinatus tendon were enveloped by a thick sheet of fibrous tissue derived from the coracohumeral ligament. Fibers from the coracohumeral and glenohumeral ligaments were found concentrated in a plane between the capsule and the tendons of the cuff. Microscopically, in the region of the supraspinatus and infraspinatus tendons, the cuff was composed of five layers defined by the attachments and orientations of the fibrous elements in each of these layers.
我们对32个大体完整的肩袖进行了研究，这些肩袖取自30具新鲜尸体，死者年龄在17至72岁之间。我们研究了肩袖的关节囊和韧带的大体解剖结构，以及肩胛下肌、冈上肌和冈下肌肌腱的组织学切片。发现肌腱会展开并相互交错，在肱骨上形成一个共同的、连续的附着点。肱二头肌肌腱被源自肩胛下肌和冈上肌肌腱的交织纤维所包裹。冈上肌肌腱的前缘和滑囊面被一层源自喙肱韧带的厚纤维组织所包绕。发现来自喙肱韧带和盂肱韧带的纤维集中在关节囊和肩袖肌腱之间的一个平面内。在显微镜下，在冈上肌和冈下肌肌腱区域，肩袖由五层组成，这五层由每层纤维成分的附着和方向所界定。
