Jerosch J, Moersler M, Castro W H
Heinrich-Heine-Universität Düsseldorf, Orthopädische Klinik und Poliklinik.
Z Orthop Ihre Grenzgeb. 1990 Mar-Apr;128(2):206-12. doi: 10.1055/s-2008-1039501.
In a biomechanical study we evaluated the passive stabilizing ligaments of 9 fresh shoulder specimens with mercury bands. While preparing the specimens we found two interesting entities: there are fibers of the coracohumeral ligament running from the humeral head to the coracoacromial ligament and there was an reproducible thickening in the posterior joint capsule. Functional evaluation shows that the coracohumeral ligament limits external rotation independently of the amount of abduction as well as inferior subluxation. The mediale glenohumeral ligament shows the highest tension in external rotation and 30 degrees abduction. The anterior inferior ligament strengthens the joint capsule in abduction and external rotation. The posterior inferior ligament shows the highest tension in abduction and internal rotation.
Immobilization in internal rotation and adduction may lead to shortening of the coracohumeral ligament, which may result in severe limitation of external rotation and abduction. Resection of the coracoacromial ligament relaxes the coracohumeral ligament leading to an increased cranio-caudal instability. The posterior inferior ligament is complementary to the anterior inferior ligament thus stabilizing the shoulder joint in abduction and internal rotation. Sparing this structure in arthroscopy with dorsal portals and restoring in the case of a rupture seems to be of value for a normal joint function.
在一项生物力学研究中，我们使用汞带评估了9个新鲜肩关节标本的被动稳定韧带。在制备标本时，我们发现了两个有趣的结构：有纤维从肱骨头延伸至喙肩韧带，以及后关节囊存在可重复出现的增厚。功能评估表明，喙肱韧带独立于外展程度和下向半脱位限制外旋。肩胛下韧带在肩关节外旋和外展30°时张力最大。前下韧带在肩关节外展和外旋时加固关节囊。后下韧带在肩关节外展和内旋时张力最大。
内旋和内收位固定可能导致喙肱韧带缩短，这可能导致外旋和外展严重受限。切除喙肩韧带可使喙肱韧带松弛，导致颅尾向不稳定增加。后下韧带与前下韧带互补，从而在肩关节外展和内旋时稳定肩关节。在采用背侧入路的关节镜检查中保留该结构，并在发生断裂时进行修复，似乎对正常关节功能具有重要意义。
