Glenohumeral ligaments

There are three glenohumeral ligaments (GHL), which are thickenings of the glenohumeral joint capsule and are important passive stabilisers of the joint. 

Gross anatomy

Superior glenohumeral ligament

• runs from the superior aspect of the glenoid and coracoid process to the fovea capitis just superior to the lesser tuberosity of the humerus
• initially anterior then anteroinferior to the long head of the biceps tendon; stabilises the biceps brachii tendon ³

Middle glenohumeral ligament

• runs from the anterosuperior glenoid, arising just inferior to the superior GHL, to the anterior aspect of the anatomic neck of the humerus

Inferior glenohumeral ligament

• sometimes referred to as the inferior glenohumeral ligament complex ⁴
• runs from the inferior two-thirds of the glenoid labrum and/or neck to the lateral humerus
• composed of three parts:
  • anterior band
  • posterior band
  • axillary pouch: laxity between anterior and posterior bands
• most important of the three GHLs as it prevents dislocation at extreme range of motion and is the main stabiliser of the abducted shoulder ^{1, 4}

Spiral glenohumeral ligament

• also referred to as fasciculus obliquus⁵
• runs from the infraglenoid tubercle and triceps tendon to the lesser tubercle of the humerus where it has a joint insertion with the subscapularis tendon
• not well-known, but consistently demonstrated on both anatomic dissection and MR arthrography ⁵

Variant anatomy

• superior GHL is almost always present (97%) but has variable origin:
  • arises with biceps brachii tendon
  • arises with middle GHL
• middle GHL is variable in size and appearance ¹ and absent in 30% ³ 
  • forms part of the Buford complex

Related pathology

• humeral avulsion of the glenohumeral ligament (HAGL)
• bony humeral avulsion of the glenohumeral ligament (BHAGL lesion)