MGHL gắn proximally labrum glenoid anterosuperior (trên dòng đầu xương), và đính kèm của nó kéo dài dọc theo các khía cạnh trước glenoid (42). Gohlke cho thấy rằng chèn glenoid MGHL tại labrum trong 86% trường hợp và tại vành glenoid trong 14% | 126 Soslowsky and Cartmell The MGHL attaches proximally to the anterosuperior glenoid labrum above the epiphyseal line and its attachment extends along the glenoid anterior aspect 42 . Gohlke showed that the MGHL glenoid insertion was at the labrum in 86 of cases and at the glenoid rim in the remaining 14 28 35 48 . The fibers of the MGHL are oriented primarily in a radial fashion 35 . The MGHL is the most anatomically variable of the three glenohumeral ligaments. Steinbeck et al. observed the MGHL in cases with an average diameter of mm range 2-5 mm and an average width of 18 mm range 6-25 mm . However in of cases studied only a rudimentary MGHL was observed 48 . Warner found that a missing or rudimentary MGHL was present in eight of 11 shoulders studied 29 . Structure The MGHL usually appears as a large fibrous band that blends into the labrum. However the it can also present as a cord-like structure which may be attached to the base of the biceps tendon and is contiguous with the anterior superior labrum giving the appearance of a sublabral hole 47 . Superiorly the MGHL appears as an intra-articular band that becomes part of the joint capsule as it descends to the humeral attachment. When the free intra-articular band is short or absent the MGHL presents only as a focal thickening or folding of the joint capsule. The attachments of the MGHL are less than 1 cm in width on both the glenoid and humerus 50 . Biomechanics Elastic Response In Situ Loads The MGHL is a factor in the passive and dynamic restraint of the glenohumeral joint. In this role the MGHL experiences in situ forces only during anterior loading coupled with a shoulder abduction of at least 30 and reaches a maximum in situ force at 60 abduction. When a 22 N compressive load is applied to the medial side of the humerus and an anterior load of 89 N is applied in the orthogonal directions the MGHL carries approx 35 N of load at 60 of abduction. In contrast when an 89 N posterior load but .
