Department of Anatomy, University of Tartu, Ravila Street 19, 50411, Tartu, Estonia.
Department of Orthopaedics, North Estonian Medical Centre Foundation, J.Sütiste Tee 19, 13419, Tallinn, Estonia.
Knee Surg Sports Traumatol Arthrosc. 2018 Jan;26(1):146-151. doi: 10.1007/s00167-017-4603-x. Epub 2017 Jun 17.
A detailed structural anatomy of the posterosuperior shoulder capsule and "glenocapsular ligament" is still rather unknown. The purpose of this study was meticulously to investigate and describe the structure and blood supply of the glenocapsular ligament on the posterosuperior shoulder joint capsule.
Sixteen fixed and twelve fresh cadaveric shoulder specimens with a mean age of 73.4 (±6.4) years were analysed. Dissection without arterial injection was performed on the 16 fixed specimens-using an alcohol-formalin-glycerol solution. Before dissection, the 12 fresh specimens received of arterial injection a 10% aqueous dispersion of latex solution. After the injection, these shoulders were also fixed in an alcohol-formalin-glycerol solution.
The glenocapsular ligament was found in all 28 specimens. Single or double parallel-running bundles of connective tissue fibres were found to form a capsular-ligamentous structure on the posterosuperior part of the joint capsule. One part of the ligament was mediosuperior, another posterosuperior. The mediosuperior part varied in shape, and in 12 of 28 cases, it was absent. The glenocapsular ligament arose from the supraglenoid tubercle and posterior part of the collum scapulae and inserted into the semicircular humeral ligament. The posterior ascending branch of the circumflex scapular artery directly fed small branches laterally and medially to the joint capsule, supplying the glenocapsular ligament and the deep layer of the joint capsule.
The glenocapsular ligament is a constant anatomical structure that consists of one or two different parts. The glenocapsular ligament and the posterosuperior part of the joint capsule appear well vascularized via the posterior ascending branch of the circumflex scapular artery.
It is the hope of the authors that this anatomical study can help surgeons who perform open or arthroscopic surgery to the posterior part of the shoulder. Knowledge of the vascular anatomy presented in this study may be especially important when incisions are made to the posterior part of the shoulder, and should minimize the risk of complications.
对肩后上方关节囊和“盂肱韧带”的详细结构解剖仍知之甚少。本研究的目的是仔细研究和描述肩后上方关节囊上盂肱韧带的结构和血液供应。
分析了 16 个固定和 12 个新鲜的肩部标本，平均年龄为 73.4（±6.4）岁。16 个固定标本采用酒精-福尔马林-甘油溶液进行无动脉注射解剖。在解剖前，12 个新鲜标本接受了 10%水性乳胶溶液的动脉注射。注射后，这些肩部也用酒精-福尔马林-甘油溶液固定。
在所有 28 个标本中都发现了盂肱韧带。在关节囊的后上方部分发现了单一或双平行运行的结缔组织纤维束，形成了一个囊状-韧带结构。韧带的一部分是中上部，另一部分是后上部。中上部的形状各异，在 28 例中有 12 例缺失。盂肱韧带起自盂上结节和肩胛颈后缘，插入半圆形肱盂韧带。旋肩胛动脉后升支直接向关节囊的外侧和内侧发出小分支，供应盂肱韧带和关节囊的深层。
盂肱韧带是一种恒定的解剖结构，由一个或两个不同的部分组成。盂肱韧带和关节囊的后上方部分通过旋肩胛动脉的后升支得到很好的血液供应。
作者希望这项解剖学研究能够帮助那些对肩部后上方进行开放或关节镜手术的外科医生。本研究中提供的血管解剖学知识在对肩部后上方进行切口时可能尤为重要，可以最大程度地降低并发症的风险。
