This cadaveric study reinvestigates the superior glenohumeral capsule in 110 shoulders using arthroscopy, dissection, histology, and functional analysis. It asks whether the superior capsule forms an integrated suspension sling analogous to the inferior glenohumeral hammock. The authors describe a previously unrecognized ligament in the posterosuperior capsule.
When a frozen shoulder loses internal rotation and standard rotator interval release only restores external rotation, this anatomy explains why. The authors describe a posterosuperior glenohumeral ligament that tightens in internal rotation. A contracted version limits internal rotation, so the release must extend posterosuperiorly to the 9-o'clock position to regain it.
Think of the superior complex as a suspension sling with reciprocal limbs: the anterior limb checks external rotation, the posterior limb checks internal rotation. This mirrors the inferior glenohumeral hammock you already know.
A practical pitfall: the normal rotator interval varies widely (2 to 8 mm at the glenoid). Do not close every opening you see, and always check external rotation after interval closure to avoid over-tightening. The framework also reframes anterosuperior and posterosuperior impingement, biceps pulley lesions, and superficial articular-sided cuff tears as damage to this superior sling.
This cadaveric study reinvestigates the superior glenohumeral capsule in 110 shoulders using arthroscopy, dissection, histology, and functional analysis. It asks whether the superior capsule forms an integrated suspension sling analogous to the inferior glenohumeral hammock. The authors describe a previously unrecognized ligament in the posterosuperior capsule.
When a frozen shoulder loses internal rotation and standard rotator interval release only restores external rotation, this anatomy explains why. The authors describe a posterosuperior glenohumeral ligament that tightens in internal rotation. A contracted version limits internal rotation, so the release must extend posterosuperiorly to the 9-o'clock position to regain it.
Think of the superior complex as a suspension sling with reciprocal limbs: the anterior limb checks external rotation, the posterior limb checks internal rotation. This mirrors the inferior glenohumeral hammock you already know.
A practical pitfall: the normal rotator interval varies widely (2 to 8 mm at the glenoid). Do not close every opening you see, and always check external rotation after interval closure to avoid over-tightening. The framework also reframes anterosuperior and posterosuperior impingement, biceps pulley lesions, and superficial articular-sided cuff tears as damage to this superior sling.