The middle glenohumeral ligament is the most variable of the three glenohumeral ligaments, absent or attenuated in up to 30 percent of normal shoulders. It provides anterior stability at mid-range abduction (45 to 60 degrees). The Buford complex is a normal variant where the MGHL is cord-like and inserts directly into the biceps anchor without an anterosuperior labrum.
| Origin | Anterior glenoid labrum (variable — may be absent in 30 percent of shoulders) |
|---|---|
| Insertion | Medial aspect of the lesser tubercle |
| Actions | Limits external rotation and anterior translation at 45 to 60 degrees of shoulder abduction |
|---|
The Buford complex (absent anterosuperior labrum with cord-like MGHL) must be recognised arthroscopically to avoid mistaking it for a labral tear and attempting repair that would restrict shoulder motion.
Normal anatomical variant with absent anterosuperior labrum and cord-like MGHL that must not be repaired as a labral tear during shoulder arthroscopy.
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