Summary
In an experimental set-up including ten shoulder specimens, increments in the acromiohumeral distance (the subacromial space) were measured on an X-ray radioscope after the vertical stabilizing structures of the glenohumeral joint had been cut. It was found that when only the supraspinatus tendons were cut, the acromiohumeral space only increased by a few millimeters. When first the coracohumeral ligament and then the proximal one-third of the anterior capsule were cut, the acromiohumeral distance was doubled in each case. Distal subluxation did not occur when only the anterior capsule was cut. When the coracohumeral ligament was also cut, the acromiohumeral distance was more than doubled. It is concluded that the most important structures in the pathogenesis of distal subluxation are first the coracohumeral ligament and then the proximal part of the glenohumeral capsule.
Zusammenfassung
An 10 Schulterpräparaten wurde der Abstand zwischen Acromion und Humerus — der subacromielle Raum — anhand von Röntgenaufnahmen, nach schrittweiser Durchtrennung der vertikalen Strukturen des glenohumeralen Gelenkes, gemessen. Es konnte dabei nachgewiesen werden, daß der subacromielle Raum nach alleiniger Durchtrennung der Supraspinatussehne nur um wenige Millimeter zunahm, jedoch verdoppelt wurde, wenn darberhinaus entweder das Ligamentum coracohumerale oder das proximale Drittel der anterioren Gelenkkapsel durchtrennt wurde. Eine distale Subluxation trat nach isolierter Durchtrennung der anterioren Gelenkenkapsel nicht auf. Erst nach Durchtrennung auch des Ligamentum coracohumerale trat eine Verdopplung des subacromiellen Raums auf. In der Pathogenese der distalen glenohumeralen Subluxation spielen das ligamentum coracohumerale und der proximale Teil der glenohumeralen Gelenkkapsel eine entscheidende Rolle.
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Ovesen, J., Nielsen, S. Experimental distal subluxation in the glenohumeral joint. Arch. Orth. Traum. Surg. 104, 78–81 (1985). https://doi.org/10.1007/BF00454241
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DOI: https://doi.org/10.1007/BF00454241