This is the first in vivo quantification of humeral head translation during standard manual laxity tests in normal shoulders. Using an electromagnetic spatial tracker pinned to the humerus and scapula, an experienced surgeon performed drawer, sulcus, push-pull, and fulcrum tests on eight normal male volunteers. The study asks: how much does the humeral head actually translate in a normal, asymptomatic shoulder?
When you feel the humeral head slide on a drawer or sulcus test, remember this paper: normal shoulders translate about 1 cm, and that alone is not pathology. The clinical rule is that translation must be interpreted alongside symptoms, apprehension, and the patient's own contralateral shoulder, never as an isolated surgical trigger.
This matters most for the exam under anesthesia, where surgeons historically over-called laxity and produced avoidable complications such as over-tightening and secondary osteoarthrosis. Use the fulcrum position to your advantage: minimal translation there reflects a competent inferior glenohumeral ligament, which is why the apprehension test localizes to that structure.
The marked intersubject variability is the practical takeaway. There is no single millimeter cutoff for normal, so bilateral comparison and clinical context drive the decision, not the measurement.
This is the first in vivo quantification of humeral head translation during standard manual laxity tests in normal shoulders. Using an electromagnetic spatial tracker pinned to the humerus and scapula, an experienced surgeon performed drawer, sulcus, push-pull, and fulcrum tests on eight normal male volunteers. The study asks: how much does the humeral head actually translate in a normal, asymptomatic shoulder?
When you feel the humeral head slide on a drawer or sulcus test, remember this paper: normal shoulders translate about 1 cm, and that alone is not pathology. The clinical rule is that translation must be interpreted alongside symptoms, apprehension, and the patient's own contralateral shoulder, never as an isolated surgical trigger.
This matters most for the exam under anesthesia, where surgeons historically over-called laxity and produced avoidable complications such as over-tightening and secondary osteoarthrosis. Use the fulcrum position to your advantage: minimal translation there reflects a competent inferior glenohumeral ligament, which is why the apprehension test localizes to that structure.
The marked intersubject variability is the practical takeaway. There is no single millimeter cutoff for normal, so bilateral comparison and clinical context drive the decision, not the measurement.