The Coracohumeral Ligament and Its Fascicles: An Anatomic Study

Area of Science:

• Anatomy
• Orthopedics
• Biomechanics

Background:

• The coracohumeral ligament (CHL) is crucial for shoulder stability and implicated in pathologies like frozen shoulder.
• Previous descriptions of CHL anatomy, including its insertions and fascicles, are inconsistent.
• The relationship between the CHL and glenohumeral ligaments requires further clarification.

Purpose of the Study:

• To provide a detailed, plane-wise description of the coracohumeral ligament's fascicular anatomy.
• To clarify the CHL's origin, insertion, and relationship with the rotator cuff.
• To offer insights relevant to surgical approaches and understanding shoulder pathologies.

Main Methods:

• Dissection of sixteen soft-embalmed and two non-embalmed shoulders.
• Histological assessment for detailed fascicular analysis.
• Morphometrical analysis to quantify anatomical features.

Main Results:

• The CHL originates from anterior and posterior edges of the coracoid process, forming two columns.
• Each column comprises superficial and deep fascicles inserting into the rotator cuff via the rotator interval.
• Fascicles fuse with surrounding connective tissue, forming a 'double necklace' around subscapularis and supraspinatus tendons.

Conclusions:

• The coracohumeral ligament consists of four distinct fascicles with complex blending into the rotator cuff.
• This intricate anatomy suggests functions beyond simple vertical stabilization of the shoulder.
• Understanding these detailed anatomical features is vital for clinical practice and biomechanical research.