Dataset Information

Middle Glenohumeral Ligament Abrasion Causing Upper Subscapularis Tear.

ABSTRACT: The middle glenohumeral ligament (MGHL) typically contributes partially to the anterior stability of the shoulder. In a very limited number of cases, the MGHL can cause abrasion on the upper edge of the subscapularis causing persistent pain symptoms for patients. The condition is exacerbated by internal rotation of the arm. In this Technical Note, we describe this entity and call it the SAM lesion (Subscapularis Abrasion from the MGHL). We present a technique of addressing this lesion.

SUBMITTER: Brady PC

PROVIDER: S-EPMC5765527 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Middle Glenohumeral Ligament Abrasion Causing Upper Subscapularis Tear.

Brady Paul C PC Grubbs Heather H Lädermann Alexandre A Adams Christopher R CR

Arthroscopy techniques 20171113 6

The middle glenohumeral ligament (MGHL) typically contributes partially to the anterior stability of the shoulder. In a very limited number of cases, the MGHL can cause abrasion on the upper edge of the subscapularis causing persistent pain symptoms for patients. The condition is exacerbated by internal rotation of the arm. In this Technical Note, we describe this entity and call it the SAM lesion (Subscapularis Abrasion from the MGHL). We present a technique of addressing this lesion. ...[more]

PMID: 29349011

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Project description:PurposeThe purpose of this morphologic cadaveric study was to quantitatively define the composition of the previously described comma tissue along with its relation to the subscapularis tendon insertion.MethodsFresh frozen cadaveric shoulder specimens were included for analysis. The coracohumeral ligament (CHL) was exposed at its origin along the base of the coracoid process and freed laterally along its course to the lesser tuberosity adjacent to the bicipital groove. The superior glenohumeral ligament (SGHL) was identified and traced along its course deep to the CHL within the rotator interval with insertion onto the superior aspect of the lesser tuberosity. The midpoint diameters of the SGHL and CHL and their composite insertional diameters on the subscapularis tendon insertion and lesser tuberosity were measured with digital calipers. The mean diameter was determined from 3 measurements taken of each ligament.ResultsEight specimens were included. With the use of digital calipers, the mean midpoint diameters of the SGHL and CHL were identified as 5.99 mm (range, 5.25-6.91 mm) and 5.13 mm (range, 4.28-5.72 mm), respectively. The composite insertional diameter of the SGHL and CHL on both the lesser tuberosity and humeral insertion of the subscapularis tendon was 9.93 mm (range, 6.69-12.05 mm). At its insertion, the SGHL and CHL comprised 54% and 46% of the comma tissue, respectively. Additionally, all specimens were identified as showing a confluence of the SGHL and CHL composite insertion with the subscapularis tendon at the point of its humeral head insertion.ConclusionsThe comma tissue is a pivotal structure for the identification, mobilization, and repair of retracted subscapularis tendon tears. Therefore, quantitative knowledge of the midpoint diameter, insertional diameter, and composite distribution of the CHL and SGHL provided by this morphologic cadaveric analysis may aid surgeons in their efforts to restore the native anatomy.Clinical relevanceSubscapularis tendon tears have often been under-addressed during rotator cuff repair. The comma tissue has been described as an anatomic structure that can aid in the identification, mobilization, and repair of retracted subscapularis tendon tears. Therefore, quantitative knowledge of this important arthroscopic landmark may aid surgeons in their efforts to restore the native anatomy.

Dataset Information

Middle Glenohumeral Ligament Abrasion Causing Upper Subscapularis Tear.

Publications

Middle Glenohumeral Ligament Abrasion Causing Upper Subscapularis Tear.

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