Unit of Clinical Anatomy, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
J Shoulder Elbow Surg. 2012 Jul;21(7):867-72. doi: 10.1016/j.jse.2011.04.034. Epub 2011 Aug 4.
To date, there are no studies about the attachment of the articular capsule of the superior shoulder joint. The aim of this study was to measure the width of the attachment of the articular capsule on the humerus, and to clarify the anatomy and the relationship to the footprint of the rotator cuff.
The attachment of the articular capsule on the greater tuberosity was exposed. The width of the attachment of the capsule and the footprint of the rotator cuff were measured.
The maximum capsular width was located at the border between the infraspinatus and the teres minor, and measured 9.1 mm. The minimum capsular width was 3.5 mm, and it was located at 10.9 mm posterior to the anterior margin of the greater tuberosity and 1.5 mm anterior to the posterior margin of the supraspinatus.
Prior studies have overestimated the rotator cuff footprint width due to the lack of discrimination between the actual cuff insertion and capsule. The attachment of the articular capsule of the shoulder joint occupied a substantial area of the greater tuberosity. In particular, at the border between the infraspinatus and the teres minor, the very thick attachment of the articular capsule compensated for the lack of attachment of muscular components. The thinnest point of the articular capsule was 11 mm posterior to the anterior margin of the greater tuberosity and very close to the posterior edge of the tapered insertion of the supraspinatus, which could contribute to the etiology of degenerative rotator cuff tears.
迄今为止,尚无关于肩关节关节囊附着的研究。本研究旨在测量肱骨头关节囊附着的宽度,并阐明其解剖结构与肩袖止点的关系。
显露小结节处关节囊的附着。测量关节囊的附着宽度和肩袖止点的宽度。
最大的关节囊宽度位于冈下肌和小圆肌的交界处,为 9.1mm。最小的关节囊宽度为 3.5mm,位于距小结节前缘 10.9mm 处,距冈上肌后缘 1.5mm 处。
由于缺乏对实际肩袖插入和关节囊之间的区分,先前的研究高估了肩袖止点的宽度。关节囊的附着占据了肱骨大结节的很大一部分。特别是在冈下肌和小圆肌的交界处,关节囊的非常厚的附着部分弥补了肌肉成分附着不足的部分。关节囊最薄处距小结节前缘 11mm,非常接近冈上肌锥形插入的后缘,这可能有助于退行性肩袖撕裂的病因学研究。