PurposeThis study aimed to morphologically and histologically investigate the relationship between deep subregions of the rotator cuff muscle and shoulder joint capsule as well as the relationship between the rotator cuff tendon or capsule and bony insertion.MethodsWe examined 13 shoulders of embalmed cadavers and measured the capsular attachments and footprints macroscopically. We also histologically examined the fibres in three shoulders.ResultsLoose attachment, which was less tight with spaced connective tissue, and firm attachment, which was tight with dense connective tissue, were found under the surface of the supraspinatus and infraspinatus. The anterior-deep and posterior-deep subregions of the supraspinatus and the middle partition and inferior partition of the infraspinatus formed firm attachments to the capsule. The mean areas of firm attachment for the anterior-deep subregion, posterior-deep subregion and middle partition were 118.8 mm2, 267.8 mm2 and 399.3 mm2, respectively, while the area of the inferior partition was small. The transverse fibres were located just lateral to the medial edge of the firm attachment area. The thick capsule had a substantial footprint. Both tendon fibres and the capsule inserted into the superior and middle facets through the attachment fibrocartilage.ConclusionsThe posterior-deep subregion of the supraspinatus and middle partition of the infraspinatus evenly occupied the capsular attachment area. The transverse fibres were located just lateral to the medial edge of the firm attachment area, and the thick capsule had a substantial footprint. Both tendon fibres and the capsule inserted into the superior and middle facets through the attachment fibrocartilage.
PurposeFat infiltration (FI) in the gluteus minimus muscle (GMin) has been reported as being restricted to the anterior part. The aim of this study was to verify whether FI is localized only to the anterior part of the GMin through the dissection of large number of elderly cadavers and to clarify the underlying mechanism of FI localized to a specific region.Materials and methodsThirty-eight hips from 20 embalmed elder cadavers were dissected for verification of FI localization. The samples of three regions – the fat infiltrated region of the anterior part (FI), the region without FI (non-FI), and the posterior region – were harvested from nine hips for the histological fiber type assessment.ResultsThe FI area was distributed at 2.6°–38° from the anterior border within the anterior part, of which function is responsible for hip extension and internal rotation and is likely reduced by disuse following aging. The number of type I fibers was lowest in FI, followed by non-FI, while the number of type I fibers was highest in the posterior. Meanwhile, the number of type II fibers was equivalent across the three regions. Atrophic type II fibers were observed in overall samples of the three regions, and grouped atrophy, which is evidence of denervation, was observed in FI and non-FI samples. Type grouping, which suggests to be reinnervated, was found in the non-FI and posterior samples but very little in the FI samples.ConclusionFI in the GMin in older adults restricted to deep within the anterior part is secondary to disuse and is strongly related to impaired denervation–reinnervation process.
Three subregions of the infraspinatus are functionally distinct. The superior subregion contributes to abduction, the middle subregion acts as a lateral rotator, and the inferior subregion has both functions.
The aim of this study was to investigate the functions of the six subregions of the supraspinatus muscle (SSP) determined by Kim et al. in Clin Anat 2007;20:648-655, using real-time tissue elastography (RTE). Twelve young male volunteers participated. The muscular hardness of the SSP was measured at rest and with contraction of the MMT3 in internal, neutral and external rotations. The SSP was functionally divided into five groups on the basis of the RTE results. These functional areas were roughly classified into three property groups: the anterior-superficial, anterior-middle, and anterior-deep subregions, which produce contractile force for abduction; the posterior-deep subregion, which produces contractile force for external rotation; and the posteriorsuperficial and posterior-middle subregions, which maintain tension. RTE was appropriate for measuring the functions of these muscular subregions. Clin.
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