MGHL !

The middle glenohumeral ligament is a band at the front of the shoulder joint; it limits outward rotation and forward slipping of the ball.

Official name: Middle glenohumeral ligament

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What it is

A band in the front of the shoulder capsule, behind the subscapularis tendon.

What it does

Limits outward rotation and forward slipping with the arm partly raised.

Key facts

Attaches: Anterior glenoid/labrum to the lesser tubercle region
Function: Limits external rotation and anterior translation
Tight in: External rotation at ~45° abduction

Relations

Medial: Anterosuperior glenoid labrum and glenoid neck, often sharing an origin with the SGHL
Lateral: Humerus near the lesser tubercle, blending with the subscapularis tendon
In front: Subscapularis tendon, which it crosses obliquely from behind
Above: Superior glenohumeral ligament (SGHL), with the foramen of Weitbrecht between them
Below: Anterior band of the inferior glenohumeral ligament (IGHL)

How to find it

Not palpable. From the posterior arthroscopic portal it is seen as an oblique band crossing in front of the upper subscapularis tendon, from the anterosuperior labrum toward the lesser tubercle.

Examination

Anterior load and shift or apprehension with the arm at about 45° of abduction loads mainly the MGHL; increased translation or apprehension in that position suggests it is torn or lax

On imaging

Best seen on axial MR arthrogram slices at the level of the subscapularis tendon; a thick, cord-like MGHL beside an absent labrum (Buford complex) or a sublabral foramen can mimic a detached labral fragment.

Clinical notes

Torn with the labrum in anterior dislocations; it is included in capsulolabral repairs
Divided as part of an arthroscopic anterior capsular release for frozen shoulder
As a main restraint to forward slip of the head in mid-abduction, it is part of the capsule tightened in a plication or capsular shift for anterior instability

Anatomical variants

Absent or very thin in a minority of shoulders (reported rates vary widely)
Thick and cord-like, as in the Buford complex
May share its origin with the SGHL or arise from the biceps anchor

Test yourself

Think of the answer, then tap the question to see it.

Which is the most variable glenohumeral ligament?

The middle glenohumeral ligament: it may be thin, a thick cord, or absent.

What is the Buford complex, which involves the middle glenohumeral ligament?

A cord-like MGHL with an absent anterosuperior labrum: a normal variant; tying it down restricts external rotation.

In which arm position does the middle glenohumeral ligament mainly limit external rotation and anterior translation?

At about 45° of abduction.

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2): ligamentum glenohumerale medium TA2 1768
Official Spanish (DeCS): Ligamento glenohumeral medio
English (TA2): Middle glenohumeral ligament
Also called: middle glenohumeral band

Sources: Terminologia Anatomica (TA2); Anatomy, Shoulder and Upper Limb, Glenohumeral Joint; Anatomy, Shoulder and Upper Limb, Shoulder.

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Representative model, for educational purposes only.

MGHL highlighted on the Durgical 3D model