Shoulder pain is a highly prevalent condition, often resulting in major life limitations, and requiring effective treatments. In this work, we explore the anatomical basis of a proposed approach to the regional anesthesia of the shoulder through a single injection under the subscapularis muscle. Bilateral experimental injections in shoulders from body donors (Radiolar ® and Methylene-Blue) under the subscapular muscle (n = 11) and cadaveric systematic dissections of other 35 shoulders from body donors were performed. Injectate spread was then qualitatively assessed. Long axis of permeable foramina in the anterior aspect of the shoulder joint capsule was measured in centimeters using a digital caliper. More than 40% of specimens had at least one permeable space (Weitbrech and/or Rouvière foramina) communicating the subscapular bursa and the articular space. We further demonstrate that an ultrasonography-guided injection under the subscapularis muscle allows the spread of the injectate through the anterior, inferior and posterodorsal walls of the articular capsule, the subacromial bursa, and the bicipital groove, as well as into the articular space for some injections. The odds of accidental intraarticular injection decrease when injecting with low volumes. This anatomical study provides a detailed description of foramina between glenohumeral ligaments. Furthermore, the data shown in this work supports, as a proof of concept, a safe alternative for rapid and specific blockade of terminal sensory branches innervating the shoulder joint capsule.

肩痛是一种非常普遍的疾病，通常会导致严重的生活受限，需要有效的治疗。在这项工作中，我们探索了通过在肩胛下肌下单次注射进行肩部区域麻醉的拟议方法的解剖学基础。在肩胛下肌（n  = 11）下对身体捐献者（Radiolar ® 和亚甲蓝）的肩膀进行了双侧实验注射，并对身体捐献者的其他 35 个肩膀进行了尸体系统解剖。然后定性评估注射扩散。通透孔长轴使用数显卡尺以厘米为单位测量肩关节囊前部的测量值。超过 40% 的标本至少有一个通透空间（Weitbrech 和/或 Rouvière孔）连通肩胛下囊和关节间隙。我们进一步证明，在超声引导下的肩胛下肌注射允许注射液通过关节囊的前壁、下壁和后背壁、肩峰下囊和二头肌沟扩散，并进入关节间隙。注射。以低容量注射时，意外关节内注射的几率会降低。这项解剖研究详细描述了椎间孔盂肱韧带之间。此外，作为概念证明，这项工作中显示的数据支持快速和特异性阻断支配肩关节囊的终末感觉分支的安全替代方案。