Jerosch J, Steinbeck J, Clahsen H, Schmitz-Nahrath M, Grosse-Hackmann A
Orthopaedic Department, Westfälische Wilhelms-University Münster, Germany.
Knee Surg Sports Traumatol Arthrosc. 1993;1(3-4):152-8. doi: 10.1007/BF01560197.
The joint capsules and the glenohumeral ligaments of 12 human shoulder specimens were histologically investigated by light microscopy. Serial sections of 15 microns thickness were cut. The tissue was stained following the haematoxylin-eosin and van Giesson techniques. For specific identification of neural elements we made use of a special silver impregnation technique, described by Novotny, for staining axons in peripheral nerves. Axons of different diameters ranging from 0.2 microns to 70 microns were discovered within the ligaments. Close to the humeral site we found small nerves forming neurovascular bundles. Within their connective tissue sheaths, the axons exhibited a serpentine configuration, which may give extra length and may allow stretching of the nerve during motion. Most of the axons discovered were located in the subsynovial layer of the ligaments. In general the diameter of these subsynovial axons did not exceed 10 microns. In addition to these axonal structures, we detected nerve endings which can be classified according to Freeman and Wyke as type II mechanoreceptors (Pacinian corpuscles). These mechanoreceptors had a diameter of approximately 150 microns. They were also positioned directly beneath the synovial membrane and close to the humeral site of insertion of the ligaments.
The described neural structures in the glenohumeral ligaments are of particular clinical importance in the light of the high incidence of recurrent shoulder dislocation and concomitant Bankart lesions. The mechanoreceptors located in the glenohumeral ligaments may control the stabilising shoulder musculature. On this premise, rupture or detachment of these ligaments will lead to a loss of a feedback mechanism.
对12个成人肩部标本的关节囊和盂肱韧带进行了组织学光镜检查。切成15微米厚的连续切片。组织采用苏木精-伊红染色和范吉森染色技术染色。为了特异性识别神经成分，我们使用了诺沃特尼描述的一种特殊银浸染技术来染色周围神经中的轴突。在韧带内发现了直径从0.2微米到70微米不等的不同直径的轴突。在靠近肱骨处，我们发现小神经形成神经血管束。在其结缔组织鞘内，轴突呈蜿蜒状，这可能会增加额外长度，并允许神经在运动过程中伸展。发现的大多数轴突位于韧带的滑膜下层。一般来说，这些滑膜下轴突的直径不超过10微米。除了这些轴突结构外，我们还检测到神经末梢，根据弗里曼和怀克的分类，这些神经末梢可归类为II型机械感受器（帕西尼小体）。这些机械感受器的直径约为150微米。它们也直接位于滑膜下方，靠近韧带的肱骨插入部位。
鉴于复发性肩关节脱位和伴随的Bankart损伤的高发生率，盂肱韧带中描述的神经结构具有特别的临床重要性。位于盂肱韧带中的机械感受器可能控制稳定肩部的肌肉组织。在此前提下，这些韧带的断裂或分离将导致反馈机制的丧失。
