[Functional anatomical principles for the operative treatment of humeroscapular periarthropathy]

The Periarthropathia humero scapularis (PHS) represents a collective term for all pathological symptoms which come from degenerative alterations of the periarticular tissue at the shoulder. Pathologically anatomic changes appear especially at the supraspinatus tendon, the so-called rotator collar and in the sliding tissue of the long biceps tendon. Abduction entails the compression of the periarticular tissue between the Tuberculum majus humeri, the Acromion and the Ligamentum coracoacromiale. Proceeding on the intraoperative observation that lime focuses and breaches of the rotator collar are predominantly under the Ligamentum coracoacromiale, we have tried to measure the functionally topographical conditions of the space with the aid of 82 corpse specimen in all. Length an width of the Ligamentum coracoacromiale as well as the space between the humerus head and the coracoacromial bow differ individually and show right-left-differences. In the case of abduction and inner rotation the space becomes narrower. The supraspinatus sinew usually already runs under the Ligamentum coracoacromiale in the neutral-0-position, especially when abduction and inner rotation are effected. Therefore the resection of this ligament seems to be appropriate as a therapy of recidivating Periarthropathia complaints.