open access

Vol 76, No 4 (2017)
ORIGINAL ARTICLES
Published online: 2017-03-27
Submitted: 2016-08-01
Accepted: 2016-12-16
Get Citation

Anatomical structure of the coracohumeral ligament and its effect on shoulder joint stability

C. Sun, B. Zhong, Z. Pan, D. Du, X. Min
DOI: 10.5603/FM.a2017.0031
·
Pubmed: 28353301
·
Folia Morphol 2017;76(4):720-729.

open access

Vol 76, No 4 (2017)
ORIGINAL ARTICLES
Published online: 2017-03-27
Submitted: 2016-08-01
Accepted: 2016-12-16

Abstract

Background: In this study, coracohumeral ligament (CHL) specimens were carefully dissected to observe its length, width, thickness and tension at different positions of the shoulder joint, thereby elucidating its effects on shoulder joint stability.

Materials and methods: Fresh frozen shoulder joints from 40 normal adult cadaveric specimens were dissected to reveal the CHL. With the shoulder joints placed at different positions, the length of the CHL and the width and thickness of the middle part of the ligament were measured. The changes in tension of the CHL were also observed. When the shoulder joint maintained the neutral position, the length of the CHL was 52.23 ± 1.02 mm and the width and thickness of the middle part of the ligament were 15.95 ± 0.59 mm and 1.46 ± 0.06 mm, respectively.

Results: When the shoulder joint moved from the neutral position to 90° external rotation, from the neutral position to 30° adduction or from the neutral position to 30° flexion/extension or when the shoulder joint is pulled down with a 5 kg weight, the CHL was elongated and thinned, maintaining a strained state. When the shoulder joint moved from the neutral position to 90° internal rotation, from the neutral position to 90° abduction or from the neutral position to 30° flexion/ extension, the CHL was shortened and thickened, maintaining a relaxed state.

Conclusions: The CHL may limit the external rotation, adduction and downward movement of the shoulder joint and the process from the neutral position to the 30° flexion/extension, maintaining shoulder joint stability.    

Abstract

Background: In this study, coracohumeral ligament (CHL) specimens were carefully dissected to observe its length, width, thickness and tension at different positions of the shoulder joint, thereby elucidating its effects on shoulder joint stability.

Materials and methods: Fresh frozen shoulder joints from 40 normal adult cadaveric specimens were dissected to reveal the CHL. With the shoulder joints placed at different positions, the length of the CHL and the width and thickness of the middle part of the ligament were measured. The changes in tension of the CHL were also observed. When the shoulder joint maintained the neutral position, the length of the CHL was 52.23 ± 1.02 mm and the width and thickness of the middle part of the ligament were 15.95 ± 0.59 mm and 1.46 ± 0.06 mm, respectively.

Results: When the shoulder joint moved from the neutral position to 90° external rotation, from the neutral position to 30° adduction or from the neutral position to 30° flexion/extension or when the shoulder joint is pulled down with a 5 kg weight, the CHL was elongated and thinned, maintaining a strained state. When the shoulder joint moved from the neutral position to 90° internal rotation, from the neutral position to 90° abduction or from the neutral position to 30° flexion/ extension, the CHL was shortened and thickened, maintaining a relaxed state.

Conclusions: The CHL may limit the external rotation, adduction and downward movement of the shoulder joint and the process from the neutral position to the 30° flexion/extension, maintaining shoulder joint stability.    

Get Citation

Keywords

coracohumeral ligament, anatomy, measurement, shoulder join, stability

About this article
Title

Anatomical structure of the coracohumeral ligament and its effect on shoulder joint stability

Journal

Folia Morphologica

Issue

Vol 76, No 4 (2017)

Pages

720-729

Published online

2017-03-27

DOI

10.5603/FM.a2017.0031

Pubmed

28353301

Bibliographic record

Folia Morphol 2017;76(4):720-729.

Keywords

coracohumeral ligament
anatomy
measurement
shoulder join
stability

Authors

C. Sun
B. Zhong
Z. Pan
D. Du
X. Min

References (26)
  1. Antunes JP, Mendes A, Prado MH, et al. Arthroscopic Bankart repair for recurrent shoulder instability: A retrospective study of 86 cases. J Orthop. 2016; 13(2): 95–99.
  2. Arce G. Primary Frozen Shoulder Syndrome: Arthroscopic Capsular Release. Arthrosc Tech. 2015; 4(6): e717–e720.
  3. Bankart AS. Treatment of congenital dislocation of the hip. Br Med J. 1913; 1(2733): 1044–1046.1.
  4. Basmajian JV, Bazant FJ. Factors Preventing Downward Dislocation of the Adducted Shoulder Joint. J Bone Joint Surg Am. 1959; 41(7): 1182–1186.
  5. Bennett WF. Subscapularis, medial, and lateral head coracohumeral ligament insertion anatomy. Arthroscopic appearance and incidence of "hidden" rotator interval lesions. Arthroscopy. 2001; 17(2): 173–180.
  6. Daly CA, Hutton WC, Jarrett CD. Biomechanical effects of rotator interval closure in shoulder arthroplasty. J Shoulder Elbow Surg. 2016; 25(7): 1094–1099.
  7. Frank RM, Taylor D, Verma NN, et al. The rotator interval of the shoulder: implications in the treatment of shoulder instability. Orthop J Sports Med. 2015; 3(12): 2325967115621494.
  8. Haghpanah B, Walley KC, Hingsammer A, et al. The effect of the rotator interval on glenohumeral kinematics during abduction. BMC Musculoskelet Disord. 2016; 17: 46.
  9. Harryman DT, Sidles JA, Harris SL, et al. The role of the rotator interval capsule in passive motion and stability of the shoulder. J Bone Joint Surg Am. 1992; 74(1): 53–66.
  10. Itoigawa Y, Itoi E. Anatomy of the capsulolabral complex and rotator interval related to glenohumeral instability. Knee Surg Sports Traumatol Arthrosc. 2016; 24(2): 343–349.
  11. Kraal T, Visser C, Sierevelt I, et al. How to treat a frozen shoulder? A survey among shoulder specialists in the Netherlands and Belgium. Acta Orthop Belg. 2016; 82(1): 78–84.
  12. Krych AJ, Shindle MK, Baran S, et al. Isolated arthroscopic rotator interval closure for shoulder instability. Arthrosc Tech. 2014; 3(1): e35–e38.
  13. Levy DM, Cole BJ, Bach BR. History of surgical intervention of anterior shoulder instability. J Shoulder Elbow Surg. 2016; 25(6): e139–e150.
  14. Li Jq, Tang Kl, Wang J, et al. MRI findings for frozen shoulder evaluation: is the thickness of the coracohumeral ligament a valuable diagnostic tool? PLoS One. 2011; 6(12): e28704.
  15. Muto T, Ninomiya H, Inui H, et al. Rotator interval lesion and damaged subscapularis tendon repair in a high school baseball player. Case Rep Orthop. 2015; 2015: 890721.
  16. Neer CS. Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am. 1970; 52(6): 1077–1089.
  17. Neer CS, Foster CR. Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder. A preliminary report. J Bone Joint Surg Am. 1980; 62(6): 897–908.
  18. Neer CS, Satterlee CC, Dalsey RM, et al. The anatomy and potential effects of contracture of the coracohumeral ligament. Clin Orthop Relat Res. 1992(280): 182–185.
  19. Nobuhara K, Ikeda H. Rotator interval lesion. Clin Orthop Relat Res. 1987(223): 44–50.
  20. Ovesen J, Nielsen S. Posterior instability of the shoulder. A cadaver study. Acta Orthop Scand. 1986; 57(5): 436–439.
  21. Ponce BA, Rosenzweig SD, Sheppard ED, et al. The effect of arthroscopic rotator interval closure on glenohumeral volume. Am J Orthop (Belle Mead NJ). 2015; 44(6): E190–E194.
  22. Robinson CM, Howes J, Murdoch H, et al. Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients. J Bone Joint Surg Am. 2006; 88(11): 2326–2336.
  23. Visonà E, Cerciello S, Godenèche A, et al. The "comma sign": an anatomical investigation (dissection of the rotator interval in 14 cadaveric shoulders). Surg Radiol Anat. 2015; 37(7): 793–798.
  24. Wellmann M, Blasig H, Bobrowitsch E, et al. The biomechanical effect of specific labral and capsular lesions on posterior shoulder instability. Arch Orthop Trauma Surg. 2011; 131(3): 421–427.
  25. Woertler K. Rotator interval. Semin Musculoskelet Radiol. 2015; 19(3): 243–253.
  26. Yang Hf, Tang Kl, Chen W, et al. An anatomic and histologic study of the coracohumeral ligament. J Shoulder Elbow Surg. 2009; 18(2): 305–310.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By  "Via Medica sp. z o.o." sp.k., Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl