Original articleThe subscapular and subcoracoid bursae: descriptive and functional anatomy
Section snippets
Material and methods
Forty-two shoulders were studied in twenty-one fresh cadavers (age range, 46–98 years, mean age, 80 years). The absence of scar and a normal range of motion were confirmed. The upper limb was harvested by detaching the scapula from the chest. The deltoid and the conjoined tendon were detached from the scapula; at this time, shoulders with full-thickness rotator cuff tears were rejected. The excursion of the subscapularis muscle was studied during passive mobilization of the glenohumeral joint
Results
With the arm at rest, the subscapularis was slightly curved around the humeral head, and the muscle bundles were parallel each together. During external rotation, the muscle bundles moved horizontally, the mean extent of the humeral attachment was 4.3 cm (extremes of 3 to 5.2 cm), and the muscle turned around the convexity of the humeral head. In abduction and external rotation, the direction of the muscle bundles changed dramatically. The humeral insertion passed from vertical and anterior to
Discussion
The distal tendon-like bands described by Klapper et al,6 in association with the intercalated proximal bands evidenced in the present results, create the same fibrous organization as in the middle deltoid as published by Gagey and Hue.5 This organization is known to increase the strength of the muscle instead of the range of excursion.
The fibrous arcs and the suspensory ligament have not been described previously; their functional importance will be discussed further.
The limited size of this
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Developmental Anatomy of the Shoulder and Anatomy of the Glenohumeral Joint
2016, Rockwood and Matsen’s The ShoulderUltrasonography of Subcoracoid Bursal Impingement Syndrome
2015, PM and RCitation Excerpt :However, subcoracoid bursal thickening or significant effusion, as depicted in this case series, can decrease subcoracoid space/coracohumeral interval relatively without absolute decrease in coracohumeral interval or subcoracoid stenosis. In addition, the subcoracoid bursa, which occasionally blends with the subscapularis bursa (in 28% of a previous cadaveric study) minimizes the friction of the superficial fibers of the subscapularis against the coracoid bursa [4]. Therefore, the bursitis can contribute to the subcoracoid impingement syndrome.
Functional Atlas of the Human Fascial System
2015, Functional Atlas of the Human Fascial SystemThe anatomy of the coracohumeral ligament and its relation to the subscapularis muscle
2014, Journal of Shoulder and Elbow SurgeryCitation Excerpt :Even in the resting neutral position, the subscapularis tendon is pressed against the spherical surface of the anterior anatomic neck and bent vertically along the lesser tubercle because it inserts into the upper margin as well as the anterior aspect of the lesser tubercle.2 Especially in the abducted and externally rotated position, the upper border of the subscapularis is coiled around the coracoid process and the humeral head becomes anteriorly prominent and pushes the subscapularis muscle forward and upward.6 To maintain the whole subscapularis during such extreme morphologic changes, the enveloping structure of the CHL must be both strong and flexible.
Current Perspectives on Rotator Cuff Anatomy
2009, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :If a patient has a rotator cuff tear, symptomatic coracoid impingement, and a narrow coracohumeral space, then all of these problems should be managed during the same surgery by performing a rotator cuff repair, anterior acromioplasty, and coracoplasty.52 Even though these studies suggest a relation between subcoracoid stenosis and the development of rotator cuff tendon tears,50,53,54 recent studies are not in agreement with this hypothesis.55,56 Tan et al.55 used MRI of the coracoid and subcoracoid space to study the association between these structures and rotator cuff tears.
Tears of the Subscapularis Tendon in Athletes-Diagnosis and Repair Techniques
2008, Clinics in Sports MedicineCitation Excerpt :The muscle belly originates on the medial two thirds of the scapular body, developing a tendinous character at the more lateral joint line and inserting at the lesser tuberosity in coalescence with the anterior shoulder capsule.2 At the joint line, subscapular and subcoracoid bursae lubricate the muscle–tendon's articulation with the more posterior joint capsule and anterior coracoid process, respectively.3 The tendon has its greatest bulk superiorly, tapering off to a thinner, more muscular layer inferiorly.2