Author

Assistant

Definition

By Gregory R. Waryasz, MD

The glenohumeral ligaments of the musculoskeletal system are characterized by their location and function.

They are part of the glenohumeral joint. They consist of fibrous dense regular connective tissue of collagen fibers.

The unique structural features are that there are three distinct fibrous bands; superior glenohumeral ligament, middle glenohumeral ligament, and the inferior glenohumeral ligament.  The inferior glenohumeral ligament has anterior and posterior components.  The ligaments are located deep to the capsule.  They radiate inferolaterally from the glenoid labrum to blend distally with the fibrous layer of the capsule near the anatomic neck of the humerus.

The glenohumeral ligaments as well as all other bones, muscles, and ligaments of the body are derived of mesodermal origin in the embryo.

The function of the glenohumeral ligaments is to help to reinforce the anterior joint capsule.  The superior glenohumeral ligament (SGHL) is the primary static restraint against translation of the arm anteriorly when the arm is at the side. The SGHL along with the coracohumeral ligament help to resist medial subluxation of the long head of the biceps tendon.  The middle glenohumeral ligament (MGHL) is the primary static resistor of anterior translation when the arm is externally rotated and abducted 45 degrees.   The anterior inferior glenohumeral ligament (IGHL) is the primary static restraint again anterior-inferior dislocation when the arm is in 9 0 degrees of abduction and external rotation.  The posterior inferior glenohumeral ligament (IGHL) is the primary static restraint against posterior-inferior translation when the arm is in internal rotation and adduction.

Common diseases include ligament tears resulting in dislocation/separation.

Commonly used diagnostic procedures include clinical history, physical exam, x-ray, and MRI.

It is usually treated with physical therapy, a sling, and NSAIDs. Surgery can be performed for more significant dislocation/separations to repair the ligaments and surrounding structures.

References

Elstrom J, Virkus W, Pankovich (eds), Handbook of Fractures (3rd edition), McGraw Hill, New York, NY, 2006.

Koval K, Zuckerman J (eds), Handbook of Fractures (3rd edition), Lippincott Williams & Wilkins, Philadelphia, PA, 2006.

Lieberman J (ed), AAOS Comprehensive Orthopaedic Review, American Academy of Orthopaedic Surgeons, 2008.

Moore K, Dalley A (eds), Clinically Oriented Anatomy (5th edition), Lippincott Williams & Wilkins, Philadelphia, PA, 2006.