Turkel S J, Panio M W, Marshall J L, Girgis F G
J Bone Joint Surg Am. 1981 Oct;63(8):1208-17.
We investigated the stabilizing mechanism of the glenohumeral joint that prevents anterior dislocation by anatomical dissections of the subscapularis, the shoulder capsule, and the superior, middle, and inferior glenohumeral ligaments in thirty-six shoulders of embalmed cadavera. We also performed roentgenographic studies of ten unembalmed cadaver shoulders in which radiopaque markers were used to demonstrate the position, tightness, and laxity of the subscapularis muscle and of the middle and inferior glenohumeral ligaments during external rotation of the shoulder at zero, 45, and 90 degrees of abduction. The subscapularis muscle and the three glenohumeral ligaments were cut in different sequences to determine their relative contributions to stability (limitation of external rotation). The conclusions from these experiments were that at zero degrees of abduction, the subscapularis muscle stabilizes the joint to a large extent; at 45 degrees of abduction, the subscapularis, middle glenohumeral ligament, and anterosuperior fibers of the inferior glenohumeral ligament provide the stability; and as the shoulder approaches 90 degrees of abduction, the inferior glenohumeral ligament prevents dislocation during external rotation.
我们通过对36具防腐尸体的36个肩部进行肩胛下肌、肩关节囊以及肩肱上、中、下韧带的解剖，研究了防止肩关节前脱位的盂肱关节稳定机制。我们还对10具未防腐尸体的肩部进行了X线研究，在尸体肩部外展0度、45度和90度时使用不透X线的标记物来显示肩胛下肌以及肩肱中、下韧带的位置、紧张度和松弛度。按不同顺序切断肩胛下肌和三条肩肱韧带，以确定它们对稳定性（限制外旋）的相对作用。这些实验得出的结论是，在外展0度时，肩胛下肌在很大程度上稳定关节；在外展45度时，肩胛下肌、肩肱中韧带和肩肱下韧带的前上纤维提供稳定性；当肩部接近外展90度时，肩肱下韧带防止外旋过程中的脱位。
