The anatomy of the glenohumeral ligamentous complex and its contribution to anterior shoulder stability

Abstract

One hundred four enbalmed cadaver shoulders were evaluated. With a dorsal approach we opened the dorsal capsule after resecting the infraspinatus and teres minor muscles. For reaching the anterior capsule and the glenohumeral ligaments, the humeral head was resected. In this way we could quantify and qualify the glenohumeral ligaments and classfy the synovial recesses based on the classification system of DePalma into type I to VI. Secondary signs of shoulder instability were documented. The superior glenohumeral ligament was missing in 6 (5.8%) shoulders, the middle glenohumeral ligament in 16 (15.4%) shoulders, and the inferior glenohumeral ligament in 7 (6.8%) shoulders. Most of the synovial recesses belonged to group I (38.5%) and III (46.2%). As a secondary sign of instability four shoulders had a Hill-Sachs fracture and a bony Bankart lesion. All four shoulders had no middle glenohumeral ligament and a large anterior type IV recess.