Subscapularis

Anatomy of subscapularis
Anatomy of subscapularis
Anatomy of subscapularis
Anatomy of subscapularis
Biceps long head stabilizers
Biceps long head stabilizers
Biceps long head stabilizers

 Subscapularis

Largest and most powerful of the rotator cuff



Important role in shoulder motion

internal rotation

anterior stabilizer of the shoulder

‘force couple’


Subscapularis anatomy

Two part of SSC insertion: by the most sup. border of LT

Four part

1. attaching area of tendinous slip *

2. insertion of superior-most part of intramuscular tendon

3. another tendinous insertion

4. muscular insertion

Subscapularis anatomy

The most cranial insertion of SSC

Normally tear initiates

Supports LHB: related with biceps dislocation

Connects SSC & SSP 

Strongest: clinically important!



Subscapularis anatomy

SSC is composed of 2 layers

deep layer  → LT

superficial layer splits into 2 bands forming sling around the LHBT 

Superficial band → LT

Deep band → GT

Biceps long head Stabilizers 

CHL

  (Coracohumeral lig.)


SGHL

  (Superiorglenohumeral lig.)


interwoven fibers of SSc & SSt





Biceps long head Stabilizers 

Medial sling

robust deep layer (medial head of CHL)

thin superficial layer ­(SGHL)

insertional footprint : top of the lesser tuberosity

     → insertion of superiorlateral SSc

Biceps long head Stabilizers 

when upper SSc tears → medial sling also tears


Comma sign 

remnant of the medial sling of the biceps

anatomic ­landmark for retracted SSc


Biceps subluxation or dislocation



Popular posts from this blog

Mirels’ Classification for pathologic fractures

Image
 Mirels’Classification Mirels H: Metastatic disease in long bones: A proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop 249:256–264, 1989. Mirels’Classification : Nature of lesion Mirels’Classification : Nature of lesion Orthopedic Radiology: A Practical Approach, Greenspan, Adam; Lippincott, 2000 Diagnosis of Bone and Joint Disorders, Resnick, Donald, W. B. Saunders Mirels’Classification : Nature of lesion Score of 8 or higher  consider prophylactic internal fixation Guideline aids in decision making, but does not serve as an absolute criterion Each patient should be evaluated individually, keeping two generally accepted principles in mind.  First, prophylactic internal fixation of an impending fracture is technically easier than fixation of an actual pathologic fracture. Second, patient morbidity is decreased with prophylactic fixation compared with fixation after the fracture. Prophylactic intramedullary fixation (↓pain and prevent subsequen...
Read more

Tibial spine fracture

Image
  Tibial spine fracture HyperExtension and femur external rotation during a fall Intercondyle eminence : Medial spine (ACL attachment) + Lateral spine ACL fiber -> tibial spine, inter-meniscal lig, MM attachment Classification Modified Meyers and McKeever classification Non-Operative management Type I, II (after C/R) Long leg cast, Slightly flexion (avoid ACL positional tension) Hemarthrosis evacuation Closed reduction (Physician’s preference for Type II) Surgical treatment Type II & III & IV Reduction method : Arthroscopic vs Open Fixation method : Suture vs Screw
Read more

Adrena incidentaloma: Diagnosis & Treatments

Epidemiology Adrenal incidentaloma is an adrenal mass lesion with a diameter of more than 1 cm incidentally detected by imaging. Adrenal incidentaloma is found in at least 2% of the population, and the prevalence increases with age. Adrenal incidentaolma is found in 1% of 40s and 7% of 70s. Most adrenal incidentalomas are endocrine-inactive adrenocortical adenomas that do not release hormones. The prevalence of endocrine-inactive adrenocortical adenoma is 60 to 85% of endocrine-active adrenocortical adenoma, endocrine-active adrenocortical adenoma is 5 to 10% of cortisol producing adenoma, aldosterone-producing adenoma is 2 to 5%, and pheochromocytoma is 5 to 10 %. 2 to 5% of the unilateral adrenal mass is a malignant adrenocortical carcinoma and 15% is metastatic cancer at other sites. Diagnosis Diagnostic evaluation should be performed in patients with adrenal masses greater than 1 cm. Two important factors must be considered. First, does the tumor secrete hormones that can harm...
Read more