Recurrent Anterior Shoulder Dislocation After Trauma with Coracoid Apophysis Fracture - A Rare Association / Luxação anterior recorrente do ombro após traumatismo com fratura apófise coracoide - Uma associação rara

Abstract Anterior dislocations represent about 96% of total shoulder dislocations, with recurrence/instability being more common in young patients. Injury of other shoulder structures is frequent, namely bony Bankart lesion. However, the association with coracoid apophysis fracture is very rare. The present article describes the clinical case of a 67-year-old man who presented to the emergency department with complaints of persistent omalgia, with acute episodes, beginning after a fall from his own height. The patient also presented history of shoulder trauma 3 months earlier, which was evaluated at another hospital. Shoulder anterior dislocation was observed radiographically, and the computed tomography (CT) confirmed bone erosion of the anteroinferior part of the glenoid (bone loss of about 50% of the anteroposterior diameter in the lower region of the glenoid), with almost complete resorption of the bony Bankart lesion (apparent in later analysis of the radiography of the initial traumatic episode). Connectedly, a transverse fracture of the coracoid apophysis (type II in the Ogawa classification) was diagnosed. The patient was submitted to surgical treatment, with anterior bone stop confection using the remnant of the fractured fragment of the coracoid supplemented by tricortical autologous iliac graft, fixed with cannulated screws (according to the Bristow-Latarjet and Eden-Hybinett techniques). In the postoperative follow-up, a good functional result was observed, with no new episodes of dislocation and no significant pain complaints. A rare association of shoulder lesions is described, and the challenge of their treatment is highlighted, given the late diagnosis, as in the case presented.

Resumo As luxações anteriores representam cerca de 96% do total de luxações do ombro, sendo a recidiva/instabilidade mais comum em pacientes jovens. A lesão de outras estruturas do ombro é frequente, nomeadamente a lesão óssea de Bankart. Contudo, a associação com a fratura da apófise coracoide é muito rara. Este artigo descreve o caso clínico de um homem de 67 anos que recorreu ao serviço de urgência com queixas de omalgia persistente, com episódios de agudização, iniciados após queda da própria altura. O paciente apresentava ainda histórico de trauma do ombro 3 meses antes, avaliado em outro hospital. A luxação anterior do ombro foi constatada radiograficamente, e a tomografia computorizada (TC) do ombro confirmou erosão óssea da vertente anteroinferior da glenoide (perda óssea de cerca de 50% do diâmetro anteroposterior na região inferior da glenoide), com reabsorção quase completa de lesão óssea de Bankart (aparente em análise a posteriori da radiografia do episódio traumático inicial). Associadamente, foi diagnosticada uma fratura transversa da apófise coracoide (tipo II da classificação de Ogawa). O paciente foi submetido ao tratamento cirúrgico, com confecção do batente ósseo anterior utilizando remanescente do fragmento fraturado do coracoide suplementado por enxerto autólogo tricortical do ilíaco, fixados com parafusos canulados (de acordo com as técnicas de Bristow-Latarjet e Eden-Hybinett). No seguimento pós-operatório, foi observado um bom resultado funcional, sem novos episódios de luxação e sem queixas álgicas significativas. Descreve-se uma associação rara de lesões do ombro, e salienta-se o desafio do tratamento das mesmas dado o seu diagnóstico tardio, como no caso apresentado.

Morphological classification and clinical significance of the coracoid process based on CT three-dimensional reconstruction / 解剖学报

Objective To provide anatomical basis for clinical treatment of acromioclavicular joint dislocation by studying the morphology of coracoid process of human scapula. Methods A total of 500 patients with shoulder injury were selected from the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University in Sichuan Province, and 300 patients were selected as subjects, including 159 cases of right shoulder and 141 cases of left shoulder. CT scan images and 3D reconstruction results of scapula of the subjects were collected. The basic morphological characteristics of coracoid process CT images of the subjects were observed, and the relevant parameters were measured, including the longest horizontal distance of the coracoid process tip and the thickness of the midpoint (cd, pp’), the distance from the upper part of the coracoid process scapula to the base and the thickness of the midpoint (mn, kk’). The distance from the apex of the coracoid process to the base of the coracoid process (ab), the longest horizontal distance of the recursion part of the coracoid process (ef), the distance of as (point s was the intersection of point a perpendicular to mn), the distance of hj (point h and j were the intersection of the base of the coracoid process and the recursion part respectively), and ik (point i was the intersection of point k perpendicular to mn and the coracoid process retraction). Results According to the morphological characteristics of coracoid process, they were divided into five types, including peanut 29. 7%; Short rod type accounted for 27. 4%; Melon seed type accounted for 12. 6%; Rod type accounted for 17. 0%; Wedge type accounted for 13. 3%. Through data comparison, it was found that the distance ef and distance hj on the left were larger than those on the right, P<0. 05. All types had statistical difference in comparison distance cd, P<0. 05. The melon seed type showed statistical differences with peanut type, wedge type, long stick type and short stick type in thickness pp’, distance ab and as of point p, P<0. 05. In the comparison of point K thickness kk’, there was statistical difference between melon seed type and other four types, P<0. 05. In the distance ab comparison, there was statistical difference between the short bar type and the other four types, P < 0. 05. Conclusion The study on the morphology of coracoid process can provide anatomical basis for clinical reconstruction of coracoid ligament to treat acromioclavicular joint dislocation.

Treatment of recurrent anterior shoulder dislocation with bristow-latarjet procedure / Tratamento da luxação anterior recidivante do ombro pela técnica de bristow-latarjet

ABSTRACT Objectives: To describe the clinical and radiographic results of patients with traumatic recurrent anterior shoulder dislocation treated with the Bristow-Latarjet procedure. Methods: Retrospective case series including 44 patients (45 shoulders) who underwent the Bristow-Latarjet procedure. The graft was fixed "standing" in 84% of the shoulders, and "lying" in 16%. Results: The follow-up was 19.25 ± 10.24 months. We obtained 96% of good results, with 2 recurrences presented as subluxation. Graft healing occurred in 62% of cases. The graft was positioned below the glenoid equator in 84% of the cases, and less than 10 mm from its edge in 98%. The external rotation had a limitation of 20.7º ± 15.9º, while the internal rotation was limited in 4.0º ± 9.6º. The limitation of rotation and the position of the graft ("standing" or "lying") did not correlate with graft healing (p>0.05). Bicortical fixation was positively correlated with healing (p <0.001). Conclusion: The Bristow-Latarjet technique is indicated for the treatment of recurrent anterior dislocations and subluxations of the shoulder. It is a safe treatment method, which can be used in people with intense physical activity. Limiting shoulder mobility does not prevent patients from returning to their usual occupations. Level of Evidence IV, Case series.

RESUMO Objetivos: Descrever os resultados clínicos e radiográficos do tratamento da luxação anterior recidivante traumática do ombro pela técnica de Bristow-Latarjet. Métodos: Série de casos retrospectiva, incluindo 44 pacientes (45 ombros) submetidos à técnica de Bristow-Latarjet. O enxerto foi fixado "em pé" em 84% dos ombros, e "deitado" em 16%, utilizando 1 parafuso metálico. Resultados: O seguimento foi de 19,25 ± 10,24 meses. Obtivemos 96% de bons resultados, sendo 2 recidivas sob a forma de subluxação. A consolidação ocorreu em 62% dos casos. O enxerto foi posicionado abaixo do equador da glenoide em 84% das vezes, e a menos de 10 mm da sua borda em 98%. A rotação externa apresentou limitação de 20,7º ± 15,9º, enquanto a rotação interna 4,0º ± 9,6º. A limitação das rotações e a posição do enxerto ("em pé" ou 'deitado") não se correlacionaram com a consolidação do enxerto. A fixação bicortical correlacionou-se positivamente com a consolidação. Conclusões: A técnica de Bristow-Latarjet está indicada para o tratamento da instabilidade anterior recidivante do ombro. É um método de tratamento seguro, que pode ser utilizado em pessoas com atividade física intensa. A limitação da mobilidade do ombro não impede os pacientes de voltarem às suas ocupações habituais. Nível de Evidência IV, Série de casos.

The axillary arch inserted to the coracoid process compressing the brachial plexus / El arco axilar insertado en el proceso coracoideo comprimiendo el plexo braquial

The axillary arch is a variant slip extending between the latissimus dorsi muscle and the pectoralis major. During educational dissection, a variant muscle was found in left arm of 70-year-old female cadaver. A slip muscle originated from the lateral margin of the latissimus dorsi and crossed the axilla obliquely. Therefore, we defined this muscular variation as axillary arch. It ran anterior (superficial) to the medial and lateral cords of the brachial plexus, and then it inserted to coracoid process. We reported this variant muscle and discussed its clinical significances.

El arco axilar es una variante que se extiende entre el músculo dorsal ancho y el pectoral mayor. Durante la disección educativa, se encontró una variante muscular en el brazo izquierdo de un cadáver de una mujer de 70 años. El músculo deslizante se originó en el borde lateral del dorsal ancho y cruzó la axila oblicuamente. Por lo tanto, definimos esta variación muscular como el arco axilar. Se extendió anterior (superficial) a los cordones medial y lateral del plexo braquial, y luego se insertó en el proceso coracoideo. Reportamos esta variante muscular y discutimos sus significados clínicas.

Acromion, coracoid and glenoid processes of scapula: an anatomical study

Background: Acromion morphology has an important role in impingement syndrome and pathogenesis of rotator cuff diseases. Coracoid process is involved in many surgical procedures of shoulder joint. Dimensions of glenoid process are essential in designing glenoid components for total shoulder replacement. Aim of the study was to measure the various dimensions and note the morphology of acromion, coracoid and glenoid processes of scapula.Methods: Fourty two scapulae (24 right, 18 left) were used and the dimensions of the three processes were measured with digital Vernier calipers.Results: The findings were as follows- length of acromion- 43.57±5.13 mm; width of acromion- 25.03±3.57 mm; acromio-coracoid distance- 33.09±7.02 mm; acromio-glenoid distance- 25.24±4.05 mm; height of coraco-acromial arch- 15.17±3.8 mm; length of coracoid- 38.73±3.72 mm; width of coracoid- 14.28±2.36 mm; tip thickness of coracoid- 8.61±1.89 mm; height of base coracoid- 12.91±2.88 mm; width of base of coracoid- 22.31±3.54 mm; height of glenoid- 34.18±3.53 mm; superior antero-posterior glenoid length- 15.35±2.35 mm and inferior antero-posterior glenoid length- 23.9±2.52 mm.Conclusions: The results will be highly relevant in orthopaedic surgery and manufacturing shoulder prosthesis.

Morphometry Of Acromion Process Of Human Scapulae

Background: The acromion process plays an important role in formation of the shoulder joint and providesstability to the shoulder joint. Acromion process resection is done in case of shoulder impingement syndrome.Materials and Methods: About 100 dry human scapulae were measured for parameters such as length, breadthof acromion process of scapula. The acromio coracoids distance and acromio glenoid distance was measuredusing vernier callipers.Observation: It was observed that the curved type of acromion process was the commonest type. Flat type is leastcommon type. The mean length of acromion process on right side is longer significantly than the left side. Thelength of acromion process on right side is significantly longer than the left side. All the other parameters(Breadth of acromion process, Acromio glenoid distance, acromio clavicular distance on right and left side wasnot significant.Conclusion: The present study provides useful data of dimensions of acromion which may help the orthopaediciansduring surgical repair around the shoulder joint. It will of interest to anthropologists when studying about theevolution of the bipedal gate

Open reduction and internal fixation for multiple injuries of superior shoulder suspensory complex with coracoid process fracture / 中国修复重建外科杂志

Objective: To investigate the effectiveness of open reduction and internal fixation for multiple injuries of superior shoulder suspensory complex (SSSC) with coracoid process fracture. Methods: Between January 2014 and October 2018, 22 patients with multiple injuries of SSSC with coracoid process fracture were treated by open reduction and internal fixation. There were 16 males and 6 females, aged from 24 to 72 years with an average age of 36.6 years. There were 10 cases of falling injury, 5 cases of traffic accident injury, and 7 cases of falling from height injury. All of them were fresh closed injuries. The time from injury to operation ranged from 2 to 17 days with an average of 6.9 days. Both X-ray film and CT showed the coracoid process fracture complicated with clavicular fracture in 14 cases, acromioclavicular joint dislocation in 12 cases, and acromioclavicular fracture in 5 cases. There were 14 cases of two places of SSSC, 7 cases of three places of SSSC, and 1 case of four places of SSSC. Results: All incisions healed in primary stage after operation. All patients were followed up 10-24 months with an average of 14.1 months. X-ray films showed that all fractures healed and the acromioclavicular joint was normal. The healing time ranged from 6 to 12 months, with an average of 6.2 months. No complications such as internal fixation failure and nonunion occurred. According to University of California Los Angeles (UCLA) shoulder scoring system, the shoulder joint function was rated as excellent in 15 cases, good in 5 cases, and poor in 2 cases at last follow-up. The excellent and good rate was 90.9%. Conclusion: Open reduction and internal fixation for treatment of multiple injuries of SSSC with coracoid process fracture is firm and reliable. Combined with active postoperative rehabilitation program intervention, it can accelerate the recovery of shoulder joint function and achieve satisfactory effectiveness.

Análisis morfométrico de la apófisis coracoides mediante tomografía computarizada en Chile / Morphometric coracoid process analysis by computed tomography in Chile

OBJETIVO: Determinar la morfometría de la apófisis coracoides (Cor) mediante tomografía computarizada de hombro (TC hombro) en población chilena. MÉTODO: 162 TC hombro (90 género femenino y 72 masculino), edad promedio 55,9 20,2 años, fueron analizadas mediante sistema computacional IMPAX. RESULTADOS: Largo total Cor promedio de 41,0 2,5 mm. Largo promedio del pilar superior de 20,5 2 mm. Altura media pilar superior de 9,2 1,2 mm. Ancho promedio pilar superior de 10,3 1,5 mm. Altura media de la base de 13,4 1,8 mm. CONCLUSIÓN: En nuestra población el pilar superior es más ancho que alto y el largo total de Cor es aproximadamente el doble del largo del pilar superior. Todas las dimensiones de Cor son mayores en el género masculino versus femenino. Al comparar la morfometría de Cor, nuestra población es similar a otros grupos étnicos según lo descrito en la literatura. Nivel de evidencia: III.

PURPOSE: Define the morphometric measurements of the coracoid process (Cor) in Chilean population through the analysis of shoulder computed tomography (shoulder CT) METHOD: 162 shoulder TC (90 females and 72 males), average age 55.9 20.2 years, were analyzed by IMPAX software. RESULTS: The mean total Cor length was of 41.0 2.5 mm. Average upper pillar length was 20.5 2 mm. The mean upper pillar height was 9.2 1.2 mm. The mean upper pillar width was 10.3 1.5 mm. Average base height was 13.4 1.8 mm. CONCLUSIONS: In our population, upper pillar is wider than high and the total Cor length is approximately twice than upper pillar length. All Cor dimensions are greater in males versus females. The Cor morphometric measurements in our population is similar to other ethnic groups as described in the literature. Level of evidence: III.

Variations Of Origin And Distance Of Axillary Nerve: A Descriptive Study

Background–Axillary nerve, one of the terminal branches of posterior cord of brachial plexus is more prone for inju-ries. Lack of proper anatomical knowledge and variations of axillary nerve leads to risk of nerve injuries. The present study describes the origin of axillary nerve, its distance of origin from tip of coracoids process. Method: Thirty brachi-al plexuses from fifteen formalin fixed human cadavers of both the sexes were studied by dissection method. Origin and branching pattern of axillary nerve and its distance of origin from the anteromedial aspect of tip of coracoid pro-cess & posterolateral aspect of acromion process was recorded. Results:Out of the 30 specimens studied, axillary nerve was originating from the posterior cord of brachial plexus in 90% of specimens, remaining 10% specimens showed a common trunk of origin of axillary nerve from posterior cord of brachial plexus. The mean distance of origin of axillary nerve from the anteromedial aspect of tip of coracoid process and posterolateral aspect of acromion process is 3.98cm & 6.30cm respectively. The axillary nerve terminated into anterior and posterior branch within quadrangular space in 29 specimens. In one specimen articular branch for shoulder joint was not directly arising from axillary nerve instead it is arising from anterior branch of axillary nerve. Conclusion: In studied population Axil-lary nerves display variations in the origin and distance of origin. Knowledge of this variation in axillary nerve is very important to clinicians, anaesthetists and orthopaedic surgeons during surgical exploration of neck, axilla and upper arm, shoulder dislocation, infraclavicular brachial plexus block and fracture of surgical neck of humerus.

Anatomic Study Of The Coracoid Process: Safety Margin For Osteotomy For Shoulder Surgery

Background: Surgical procedures as coracoid osteotomy, transfer, and fixation are used for management ofrecurrent anterior shoulder instability. However, the peculiar anatomy of bony and soft tissue footprints of thecoracoid, as they relate to these surgical procedures, need further detailed studies owing to its clinical importance.Aim of the work: to obtain safety margin for osteotomy of the coracoid process.Materials and methods: The material of this work included twenty upper limbs of formalin preserved specimensobtained from the dissecting room of anatomy department, faculty of medicine, Alexandria University. Dimensionsof the coracoid process were recorded. Anatomical measurements between the tip of the coracoid process to theanterior and posterior margins of the tendon of pectoralis minor were recorded. Distances between the tip of thecoracoid process and the anterior and posterior margins of coracoacromial ligament, coracohumeral ligament,and the most distal point of conoid and trapezoid ligaments were recorded.Results: The mean length, width, and height of the coracoid were 4.25, 1.4, 1.16 cm respectively. The meandistance between the tip of the coracoid process to the anterior and posterior margins of pectoralis minor were1.07 and 2.04 cm respectively. The mean distance between tip of coracoid process and coracoacromial ligament(anterior and posterior margins), coracohumeral, conoid and trapezoid ligaments were 1.32, 2.19, 1.11, 3.70and 2.73 cm respectively.Conclusion: A safety margin of 2.35 cm from the tip of the coracoid process is recommended to avoid injury ofcoracoclavicular ligament. This distance was correlated with the distance between the tip and the posteriormargin of pectoralis minor muscle.

Coracoid Process Morphology using 3D-CT Imaging in a Malaysian Population

Introduction: The aims of this study are to define the coracoid process anatomy in a Malaysian population, carried out on patients in Hospital Serdang with specific emphasis on the dimension of the base of coracoid process which is important in coraco-acromial (CC) ligament reconstruction, to define the average amount of bone available for use in coracoid transfer, and to compare the size of coracoid process based on gender and race, and with findings in previous studies. Materials and Methods: Fifteen pairs of computed tomography (CT) based 3-dimensional models of shoulders of patients aged between 20 to 60 years old were examined. The mean dimensions of coracoid were measured and compared with regards to gender and race. The data were also compared to previously published studies. Results: The mean length of the coracoid process was 37.94 ± 4.30 mm. Male subjects were found to have larger-sized coracoids in all dimensions as compared to female subjects. The mean tip of coracoid dimension overall was 19.99 + 1.93mm length x 10.03 + 1.48mm height x 11.63 + 2.12mm width. The mean base of coracoid dimension was 18.96 + 3.71mm length x 13.84 + 1.76mm width. No significant differences were observed with regards to racial denomination. The overall coracoid size measurements were found to be smaller compared to previous studies done on the Western population. Conclusion: This study may suggest that Malaysians have smaller coracoid dimension compared to Caucasians. The findings further suggest that the incidence of coracoid fracture and implants pull out in Malaysian subjects may be higher.

Identification of cephalic vein in the deltopectoral groove and its surgical relevance.

Introduction: Identification and recognition of the cephalic vein (CV) in the deltopectoral triangle is of critical importance when considering emergency procedures. Therefore, the present cadaveric study was undertaken to identify the CV in the deltopectoral groove and its termination in the axillary vein with respect to the relevant anatomical landmarks. Material and methods: The length of the CV was taken from the lowest limit of the deltopectoral groove to its draining point into the axillary vein. The coracoid process (CP), first cost-chondral junction (CCJ) and the midclavicular point (MCP) were used as the landmarks and their distances from the drainage point of CV into the axillary vein were measured. Results: In all cadavers, the CV traversed the deltopectoral groove and terminated into the axillary vein. The mean length of the CV was 15.46 ± 1.57 cm. The distances of its drainage point from the sternoclavicular joint, midclavicular point, first costo-chondral junction and the coracoid process were 8.26 ± 0.99 cm, 3.51 ± 0.8 cm, 5.66 ± 0.71 cm and 5.16 ± 0.8 cm respectively. Conclusion: The present anatomical study describes the location of cephalic vein in relation to the anatomical landmarks which would be commonly used in the intervention procedures in this region.

Optimal computer aided measure for screw internal fixation in the cavitas glenoidalis through human coracoid process of scapula / 解剖学报

Objective To investigate a special optimization technique for computer aided measure, and provide anatomical basis for screw internal fixation in the cavitas glenoidalis through the coracoid process of scapula. Methods Thirty accurate scapula models were reconstructed from CT data sets. First, special optimization objective function was designed for single screw internal fixation configuration, and the optimal placement of screw was found automatically under constraints. Then, the placements of double screws internal fixation configuration were searched taking advantage of principal component analysis. Finally, statistical measure data were provided according to new anatomical reference landmarks for clinical use. Results For single screw internal fixation configuration, the distance from the optimal screw entry point P to the acromion process point X was (39.15±2.28) mm, to the coracoid process point Y was (28.66±2.68) mm, to the angulus superior point Z was (61.13±6.57) mm;The angle was (81.27±7.15)° between PX and PY, and (133.27±6.84)° between PX and PZ. The mean inclination of the lag screw was (104.08±4.41)° for the angle with line PX, (101.29±3.51)° with line PY, and (76.23±5.03)° with line PZ. For double screws configuration, the distance from the original single screw entry point P to the screw entry point E was (5.12±1.37)mm,to the screw entry point F was (3.88±0.94)mm. The angle between the long axis of coracoid process and line EF was (27.41±3.51)°. Conclusion The automatic optimization technique for computer aided measure is very efficient and has many advantages over the conventional manual dissection methods, and is convenient to design new anatomical reference landmark system for clinical use.

Surgical Treatment Using Anchor Suture of Coracoid Process Fracture with Acromioclavicular Joint Dislocation: A Case Report

PURPOSE: This study examined the outcomes of closed reduction and fixation of the coracoid process fracture using a suture anchor in a patient with combined acromioclavicular dislocation for which the coraco-clavicular ligament was intact. MATERIALS AND METHODS: A 26 year-old male patient with a coracoid process fracture that was associated with a type III acromioclavicular joint dislocation was operated on with anchor suture fixation. This is the first trial of this operative procedure. RESULTS: At the postoperative follow-up at 3 months, complete union of the coracoid process fracture was seen. The shoulder had a full range of motion and the shoulder function was normal. CONCLUSION: Closed reduction and fixation using one suture anchor for treating coracoid process fracture is a safe, effective procedure.

Acromioclavicular Separation with the Fracture of the Coracoid Process: 2 Cases report

The acromioclavicular separation (AC separation) is a common injury, which is often accompanied by the rupture of the coracoclavicular ligament (CC ligament) in severe occasions. In rare forms of AC separation, the fracture of the coracoid process would occur rather than the rupture of the CC ligament. Only 31 cases of such injury have been reported in the English literature. We present 2 additional cases with literature review. The fracture of the coracoid process is not readily seen on anteroposterior shoulder radiograms. Severe AC separation without widening of CC distance on anteroposterior shoulder radiogram heralds the fracture of the coracoid process.

Operative management of type Ⅱ fracture of the distal clavicle / 中华创伤骨科杂志

Objective To introduce an operative method for the treatment of type Ⅱ fracture of distal clavicle. Methods The clavicle and coracoid proc ess were compressively fixed with screw in, and the coracoclavicular ligament wa s repaired in 24 cases of type Ⅱ fracture of the distal clavicle. Results The fractures healed in all the cases with good function of joint, and without screw loosening or traumatic arthritis. Conclusion The operative method is an ideal m anagement for the treatment of adult type Ⅱ fracture of distal clavicle, due t o its easy handling, reliable fixation, exact curative effects and less complica tions.

Morphometric Study on the Coracoacromial Arch, the Acromial Articular Surface, and the Glenoid Cavit of the Scapula in Koreans / 체질인류학회지

The present study was performed to provide an anatomical basis of the coracoacromial (CA) arch and the articular surfaces of the scapula which can be applied to the diagnosis and treatment of some common shoulder problems. The standard dimensions and the range of variation of the CA arch, the acromial articular surface and the glenoid cavity were investigated in 114 dry scapulae obtained from 57 (male, 35 ; female, 22) Korean cadavers ranging in age from 18 to 97 years (average age of 67). The results were as follows : 1. The length (46.3mm), width(25.2mm), thickness (8.2mm) and height (4.5mm) of the acromion were measured. The length, width and thickness were significantly larger in the males. The slope of the acromion was 51.5°, and the slope of the scapular spine was 118.5°. 2. The height (13.5mm), slope of the root (138.4°) and the horizontal part (25.3°) of the coracoid process, and the angle between the root and the horizontal part (106.6°) were measured. There were no significant differences between sexes and sides in all morphometric values related to the coracoid process. 3. The length (67.6mm) and height (24.7mm) of the CA arch, the height of the CA ligament from the supraglenoid tubercle (13.1mm), and length of the CA ligament (27.6mm) were measured. Both the length and height of the CA arch and the length of the CA ligament were significantly larger in the males. The slope and anterior and posterior angles of the CA arch were 16.8°, 42.2°, and 34.7°, respectively. 4. The long (13.8mm) and short (8.0mm) diameters of the acromial articular surface were measured, and both diameters were significantly longer in the males. The acromial articular surface was 8.4mm away from the tip of the acromion and extended 1.4mm inferiorly below the inferior surface of the acromion. 5. The long (34.8mm) diameter, and superior (15.0mm), middle (19.5mm), and inferior (25.6mm) short diameters of the glenoid cavity were measured. The long and both superior and inferior short diameters were significantly longer in the males.

Fracture of the Coracoid Process Associated with Acromioclavicular Dislocation: A Case Report / 대한정형외과학회잡지

Fracture of the coracoid process are rare and those associating with a complete acromioclavlcular separation is even more rare. The mechanism of injury may be attributed to either direct or indirect trauma. Most coracoid fractures are minimally displaced because It is by maintained by the coracoclavicular ligament and coracoacromial ligaments. Usually good result is obtained In the coracoid fracture by non-operative treatment. On the other hand open reduction Is rarely Indicated. The case we are reporting was treated by open reduction and Internal fixation of the acromloclavicular joint using two Kirschner wires, and screw fixation was done for the fracture of the base of the coracoid process. Review of the literature ls also done.