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In looking at the anatomy of the glenohumeral ligaments,

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it's probably helpful for me to just introduce

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the concept of some anterior variations, which are

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known as Buford variations, or Buford complexes.

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So, the superior labrum is going to be

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smaller at the top than it is at the bottom.

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And, this is a hard and fast rule.

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So as you go down, the labrum should get blacker and bigger,

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and more triangular, more clearly triangular like this.

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And if it doesn't, you've got a problem.

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But starting up high, we've got our

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small, we've got our small labrum here.

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Let me color it, right there.

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And then taking off from it, we have the superior

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glenohumeral ligament, which is right there.

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So what if you didn't have a labrum, or you had a

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labrum that wasn't really anchored onto the glenoid?

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So in other words, the labrum was, say, over here.

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And then the SGHL came off that, and you had a

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big space between the labrum and the underlying

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glenoid, so yellow for the space, or recess.

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And that might be filled with fluid.

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It would look like, to you, that

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the labrum has come detached.

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Now, what'll strike you is, nothing's inflamed.

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There's no effusion.

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The rest of the structures are in their normal position.

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And this thing looks like a large, gray mass.

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Now, I didn't color it gray, I made it red.

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And I'll stay with red, because it's just easier to see.

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But it can get, it can get fairly large.

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Let me see if it'll color for me.

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Then as we scroll down, the middle glenohumeral

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ligament comes off the undersurface of it.

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So if we were looking at it sagittally, let's say we

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had a piece of labrum here, and we had the SGHL coming

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off that, the MGHL might come off conjointly and be

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very thick like a big fat cord, or a cord-like MGHL.

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To make matters even more complex, if the biceps has

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a very far anterior takeoff, It may take off right

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in the neighborhood, and that adds to this mass

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like character of this triangular black structure

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in the front with this big, gaping recess behind it.

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That is really the essence of the Buford

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variations or the Buford complexes.

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And you can see that the biceps might come off in the front

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or might come off in the back and not, not be part of it.

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The MGHL might be very thick and cord-like.

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And come off right underneath it, or

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it might come off a little bit lower.

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So this is why we refer to these as Buford variations.

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And we're going to show you an example of such

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in an actual case so that you get a feel for it.

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But this is a quick, nice introduction to it.