Compared Study Of The Shoulder Joint With Cross-sectional Anatomy And MRI

Objective:Use the collodion slice technique and magnetic resonance imaging compared with to investigate the critical region of shoulder joint. (1) The long head of biceps tendon and its stable instalment(the subscapularis tendon, the coracohumerus ligament, superior glenohumeral ligament). (2) Tthe rotator interval and its inner structures. (3) The glenoid labrum and glenohumeral ligament. This study expect to provide the morphological basis for the diagnosis of clinic and surgical treatment of relative diseases.Methods:The materials were obtained from 2 men formalin fixed adult man cadavers without obvious shoulder disease. Specimens were cut from the lateral portion of clavicle to the superior portion of the shaft of humerus. According to the demand of research, the specimens were dissected into 16cm; we removed some tissue which had unuseful for our study and embedded the remained tissue with collodion,and then made series cross sectional planes about 0.5-1mm thickness by cerebrosection. Put the planes in order and took pictures. We choose some critical slices which were magnified about8 to 10 times and observe them.We choose 2 volunteers to the second affiliate hospital of TIJMU and obtain the picture of MRI and collect some picture of affiliate hospital of CDMC. To compared with our sectional slices.Results:(1) The long head of biceps tendon and its instalment.The long head of biceps tendon locate in the superior third part of the humerus and pass through the biciptical groove,abruptly curve into the interarticular and insert into the superior tubercle of scapular, the fascia of deltoid and peremajor muscle, subscapuras tendon and the sheath of LHB, CHL, SGHL cover it and form the instablion. The subscapularis tendon does not termined into the lesser tubercle and across through the bicipital groove and the anterior aspect of greater tubercle. And attach into the supraspinarus tendon in the lateral aspect of the greater tubercle. The sheath of LBH surround and encircle the LHB. The anterior and posterior wall are thickened and form a synoviales in the lateral aspect of bicipital groove. the anterior vascular pass through the a bundle of fibers from the capsule filled the interval between the subscapularis tendon and the anterior wall and insert into the greater tubercle.The medical aspect of the sheath is the complex of CHL and SGHL. A branch of CHL which originate in the anterior aspect of lesser tubercle and encircle the LHB, and blend with CHL and form the complex.and reinforce the LHB anteriormedically. the SGHL parallel with the LHB and surrounding the LHB with a U-shape in the level of the entrance of bicipital groove, a portion of fibers blend into the subscapuras tendon.(2)The rotator intervalThe rotator interval locate between the subscapularis tendon and the supraspinarus tendon the interval is not a weak space and a lot of anatomic structures pass through in it for CHL CAL SGHL the subacromonaldeltoid bursa.the thickness of the CHL divide into two portion:superior part and inferior part, the inferior part is thiner and insert into the tubercle, the superior part is the extension of pecroralis minor tenon.It is thicker and blend with the supraspinas tendon posteriorly. The supraspinas tendon insert into the greater tubercle and split a fibers form a slip covered the greater tubercle.MT, SSCT and SSPT form a entity through the slip and contribute for the function of shoulder together. The best level reveal the appearance is the oblique sagital level and cronal level(3)The glenoid labrum and GHLThe glenohumeral ligaments reinforce the anterior and inferior portions of the capsule. The middle glenohumeral ligament attaches on the anterosuperior labrum or the neck of the scapula. It have a cordlike appearance and correspond to a capsular fold。The inferior glenohumeral ligament has an anterior and a posterior band and an intermediate portion, the axillary recess. All structures together are sometimes referred to as the "inferior glenohumeral ligament complex." The axial view is the best sequence for labrum.Conclusions:1 The subscapularis tendon is not inserted into the lesser tubercle and across the bicipital groove and merge with the insertion of supraspinatus tendon. 2 A small fibers of the SGHL blend into the superior margin of the subscapularis tendon, The CHL and SGHL is one of the most important structures preventing LHB from dislocation.3 Surgons should reconstruct the anatomic structures to avoid the recourrace of dislocation.4 The supraspinatus tendon is intimate with other rotator cuff tendons,so it can play a critical role in the development of shouder disease.5 There are many normal variations of he labrum and GHL, It is esstenal to understand the details of these structures in clinic diagnosis and treatment.