An anatomical study of the fetal superior capsule of the glenohumeral joint.

Autor: Clavert P; Faculté de médecine, institut d'anatomie, 4, rue Kirschleger, 67085 Strasbourg cedex, France. Electronic address: philippe.clavert@chru-strasbourg.fr., Bruyere A; Faculté de médecine, institut d'anatomie, 4, rue Kirschleger, 67085 Strasbourg cedex, France., Ollivier I; Faculté de médecine, institut d'anatomie, 4, rue Kirschleger, 67085 Strasbourg cedex, France., Nourrissat G; Clinique des Maussins, 67, rue de Romainville, 75019 Paris, France., Lädermann A; Service d'orthopédie et traumatologie, hôpital de la Tour, avenue J.-D.-Maillard 3, 1217 Meyrin, Switzerland; Faculté de médecine medicine, université de Genève, rue Michel-Servet 1, 1206 Geneva, Switzerland; Service d'orthopédie et traumatologie, Department de Chirurgie, rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.
Jazyk: angličtina
Zdroj: Orthopaedics & traumatology, surgery & research : OTSR [Orthop Traumatol Surg Res] 2021 Dec; Vol. 107 (8S), pp. 103073. Date of Electronic Publication: 2021 Sep 22.
DOI: 10.1016/j.otsr.2021.103073
Abstrakt: Introduction: The superior part of the glenohumeral joint capsule has an intimate relationship with the tendons of the rotator cuff and the tendon of the long head of the biceps. One of the strategies currently proposed in the event of a massive cuff rupture is to reconstruct this superior capsule. The main objective of this anatomical study was to describe the superior joint capsule of the embryonic glenohumeral joint and its relationship to the tendons of the rotator cuff.
Hypothesis: The hypothesis was that this structure was an anatomical entity, morphologically identifiable from the embryogenesis of the joint (more pronounced tissue boundaries in the fetus).
Material and Methods: In total, 101 continuous fetal anatomical sections (4 fetuses of 336mm), in the frontal plane, made it possible to identify and measure: diameters of the humeral head and glenoid, dimensions of the joint capsule insertion zone at the level of the greater tubercle, as well as the different thicknesses of this insertion zone. The ratios above the head of the biceps and against the superior labrum were also measured.
Results: At the level of its distal insertion on the greater tuberosity, the thickness of the superior joint capsule varies on average between 0.8mm laterally and 1.2mm next to the tendons of the supraspinatus and infraspinatus; the thickness is 0.9mm next to the middle part of the supraspinatus tendon (the "rotator cable" zone). For its insertion at the level of the glenoid labrum, the superior capsule measures 0.6mm thick on average. The capsule around the tendon of the long head of the biceps is 1.5mm thick on average.
Discussion: Here, we confirm the existence of this superior joint capsule, which can potentially be reconstructed. It is inserted on the greater tubercle covering 30 to 60% of its surface with variations in thickness. The joint capsule is fused to the supraspinatus tendon at the rotator cuff insertion area, preventing independent reinsertion of the tendon.
Level of Evidence: IV; anatomical study.
(Copyright © 2021 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: