Relevant Anatomy of Glenohumeral Instability.

Last updated Friday, February 04, 2005

The rotator cuff

Tendons of the rotator cuff

The tendons of these muscles blend in with the capsule as they insert to the humeral tuberosities (Clark and Harryman, 1992). Thus, in reconstructions that require splitting of these muscles from the capsule, this splitting is more easily accomplished medially, before the blending becomes complete. The nerves to these muscles run on their deep surfaces: the upper and lower subscapular to the subscapularis and the suprascapular to the supraspinatus and infraspinatus. Medial dissection on the deep surface of these muscles may jeopardize their nerve supply. (Yung and Harryman, 1995)

The cuff is relatively thin between the supraspinatus and the subscapularis (the "rotator interval"). This allows the cuff to slide back and forth around the coracoid process as the arm is elevated and lowered. Splitting this interval toward the base of the coracoid may be helpful when mobilization of the subscapularis is needed.

The tendon of the long head of the biceps originates from the supraglenoid tubercle. It runs beneath the cuff in the area of the rotator interval and exits the shoulder beneath the transverse humeral ligament and between the greater and lesser tuberosities. It is subject to injury on incising the upper subscapularis from the lesser tuberosity. In the bicipital groove of the humerus this tendon is endangered by procedures that involve lateral transfer of the subscapularis tendon across the groove.

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