Bálványossy P
Unfallchirurgische Abteilung, Krankenhaus Csepel, Ungarn.
Unfallchirurg. 1990 Jan;93(1):27-31.
Anatomic dissection of 220 cadaver shoulders was performed to find out more about the static stabilizers of the shoulder joint. The static stabilizers, i.e. the glenohumeral ligaments, were always found to be present and strong in healthy shoulders. It was revealed that in anatomic preparations with all the organs removal except the synovial capsule, the capsule ligaments completely stabilized the joint. Anterior dislocation at 45 degrees of abduction was prevented by the superior and medial glenohumeral ligaments, while at 90 degrees of abduction the inferior glenohumeral ligament prevented dislocation. When anterior dislocation has occurred even the coracohumeral ligament must be ruptured. A new finding recorded is that the glenoid labrum is the origin of the inferior glenohumeral ligament and not a triangular static organ enlarging the socket and having a similar function to the menisci in the knee. This ligament is the most important ventral stabilizer of the humeral joint. With the conventional arthrotomy technique the medial and inferior ligaments are immediately cut through and therefore cannot be seen. The inferior glenohumeral ligament must be reconstructed in cases of anterior recurrent dislocation.
对220具尸体肩部进行解剖，以进一步了解肩关节的静态稳定结构。静态稳定结构，即盂肱韧带，在健康肩部总是存在且结构完整。研究发现，在仅保留滑膜囊而去除所有其他组织的解剖标本中，关节囊韧带能完全稳定关节。在外展45度时，上盂肱韧带和中盂肱韧带可防止肩关节前脱位；在外展90度时，下盂肱韧带可防止脱位。若发生肩关节前脱位，即使喙肱韧带也必然断裂。一项新发现是，盂唇是下盂肱韧带的起点，而非一个增大关节窝并具有类似膝关节半月板功能的三角形静态结构。该韧带是肩关节最重要的前侧稳定结构。采用传统关节切开术时，中盂肱韧带和下盂肱韧带会被直接切断，因此无法观察到。复发性肩关节前脱位时，必须重建下盂肱韧带。
