著者

吉村 英哉 望月 智之 秋田 恵一 加藤 敦夫 山口 久美子 新井 隆三 菅谷 啓之 浜田 純一郎

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.35, no.3, pp.707-710, 2011 (Released:2011-12-21)

参考文献数

18

被引用文献数

1

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Our previous study revealed that the most proximal portion of the subscapularis tendon extended a thin tendinous slip to the fovea capitis of the humerus, and that the coracohumeral ligament (CHL) together with the SGHL was shaped like a spiral sling, supporting the long head of biceps and attached to the tendinous slip. Little information is available, however, regarding the relationship between CHL and the insertion of subscapularis on the lesser tuberosity. To clarify the significance of CHL, we examined the morphology of CHL and the subscapularis insertion in 20 cadaveric shoulders. The anterior portion of CHL arises from the base of the coracoid process and fans out laterally and inferiorly on the subscapularis. The fibers envelop the tendinous portion of the subscapularis on either side. As a result, the ligament forms a cable-like anterior leading edge over the rotator interval. The subscapularis tendon can appear in relative anatomic position unless the arm is brought into internal rotation and relaxation is achieved. We also demonstrated that CHL was associated with opening the bicipital sheath along its medial border during shoulder elevation. The coracohumeral ligament might contribute to the stability of the subscapularis tendon and to the morphology of the bicipital groove.

著者

山口 久美子 加藤 敦夫 秋田 恵一 望月 智之

出版者

日本肩関節学会

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.34, no.3, pp.587-589, 2010-08-04

参考文献数

4

被引用文献数

1

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Coracohumeral ligament (CHL) is situated in the gap between the supraspinatus and the subscapuralis. There are only a few studies concerning the CHL after Clark and Harryman II (1992) in spite of the important role that fills the rotator interval. In this study, we dissected six shoulders of three cadavers to observe the spatial distribution of the CHL in detail. Four shoulders of two cadavers were processed to analyze the attachment of the rotator cuff and the capsule histologically. For the histological analyses, whole parts of the CHL were removed emblock, and serial sections were made from proximal to distal. In gross anatomy, the CHL attached to the proximal lateral surface of the coracoid process in its most proximal part. It filled the rotator interval between the supraspinatus and the subscapularis. Most distal part of the CHL extended to both the superior and inferior surfaces of supraspinatus, and both the anterior and posterior surfaces of subscapularis. In the rotator interval, CHL connected to the superior glenohumeral ligament (SGHL). There was no clear border between the CHL and the SGHL in either gross anatomy or histologically. Histologically, the CHL contained only fine loose slack collagen fibers without any dense fiber that is normally observed in a ligament. With flexion and the extension, the CHL were stretched to pull the rotator interval. From these observations, the CHL seems to work with the SGHL for the stability of the long head of the biceps during shoulder movement.

著者

田崎 篤 二村 昭元 加藤 敦夫 山口 久美子 秋田 恵一 星川 吉光 望月 智之

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.36, no.3, pp.787-790, 2012

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<B>Background:</B> Anatomical information of the insertion of the capsule around the glenoid is essential to recognize the pathological mechanism of shoulder disorders and perform better surgery.<BR><B>Methods:</B> Twenty five shoulders were dissected to investigated the morphology and size of the insertion of the capsule around the glenoid. We treated superior capsule as capsule-CHL. The location of glenoid rim was expressed as the location of the clock face of the glenoid.<BR><B>Results:</B> In the superior margin of the glenoid, the insertion of the capsule-CHL complex covered broadly to the base of the coracoid process in a triangular shape. Belt-like shape insertion was observed in posterior margin of the glenoid. Whereas as you followed anterior to the anteroinferior part, 4-5 oclock was thicker, then gradually thin down toward inferior. The average maximum width of the anterior and posterior insertion was 8.1mm (6.6-10.1mm)and 8.1mm (6.6-10.1mm), respectively. Although the width of insertion tapered, the capsule sent its fibers and connected to the lateral part of the LHT. Its attachment was observed as a thick portion from inside of the joint. This portion was observed as the posterior inferior gulenohumeral ligament.<BR><B>Conclusion:</B> The fact of thick attachment of the capsule on the glenoid rim should be considered when we perform surgery for shoulder instability. Fibrous connection between the capsule and LHT, which compensates for thin capsular attachment at inferior part, reinforces inferior stability. Since contraction of LHT pulls the inferior capsule inferiorly, this mechanism may have a role to avoid impingement of the inferior capsule.

著者

秋田 恵一 山口 久美子 望月 智之 小泉 政啓

出版者

東京医科歯科大学

雑誌

基盤研究(C)

巻号頁・発行日

2008

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肩関節周囲の構造については、臨床の技術の向上にともない、ますます詳細な理解を必要とするようになった。そこで、本研究では肩関節周囲筋の解剖を見直し、総合的に新たに評価を行い、手術、診断といった臨床応用への基盤を形成する。また、肩関節の成り立ちを比較解剖学的に検討し、ヒトの解剖学的な理解に役立たせる。本研究の結果、非常に多くの解剖学的な新知見が得られ、臨床への応用が期待されることになった。また、比較解剖学的な知見から、ヒト肩関節の構造について、より理解が深まったと考えられる。