ANATOMIC AND FUNCTIONAL-ASPECTS OF THE KINETICS OF THE SHOULDER JOINTCAPSULE AND THE SUBACROMIAL BURSA

This anatomic study was devoted to the kinetics of the shoulder joint and especially the subacromial region. Following dissection of the sho ulder joint capsule and subacromial region of 80 unpreserved shoulder joints, the anatomic relationships of the subacromial space in the neu tral position and in continuous abduction (30 degrees, 60 degrees and 90 degrees with fixed scapulae) were examined. These investigations we re supplemented by histologic preparations. In the course of our exami nations we discovered a gliding mechanism of the subacromial bursa. Mo reover, we found a subcoracoid attachment of the shoulder joint capsul e and a precoracoid ligamentous connection running between the short h ead of the biceps brachii m. and the coracoacromial ligament. We terme d this the coracoid aponeurosis, which facilitates gliding behaviour o f the shoulder joint capsule beneath the coracoid process. In view of this gliding mechanism of the subacromial bursa and the coracoid apone urosis, discovered in the course of our investigations, we have to rea ssess the kinetics of the sub-acromial and subcoracoid space. Further, we should reconsider our operative technique in cases of the subacrom ial or subcoracoid impingement syndrome.