We investigated the stabilizing mechanism of the glenohumeral joint that
prevents anterior dislocation by anatomical dissections of the
subscapularis, the shoulder capsule, and the superior, middle, and inferior
glenohumeral ligaments in thirty-six shoulders of embalmed cadavera. We
also performed roentgenographic studies of ten unembalmed cadaver shoulders
in which radiopaque markers were used to demonstrate the position,
tightness, and laxity of the subscapularis muscle and of the middle and
inferior glenohumeral ligaments during external rotation of the shoulder at
zero, 45, and 90 degrees of abduction. The subscapularis muscle and the
three glenohumeral ligaments were cut in different sequences to determine
their relative contributions to stability (limitation of external
rotation). The conclusions from these experiments were that at zero degrees
of abduction, the subscapularis muscle stabilizes the joint to a large
extent; at 45 degrees of abduction, the subscapularis, middle glenohumeral
ligament, and anterosuperior fibers of the inferior glenohumeral ligament
provide the stability; and as the shoulder approaches 90 degrees of
abduction, the inferior glenohumeral ligament prevents dislocation during
external rotation.