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. 2015 Dec 6;47(3):337-43.
doi: 10.1016/S2255-4971(15)30108-7. eCollection 2012 May-Jun.

OSTEOTOMIES OF THE CORACOID PROCESS: AN ANATOMICAL STUDY

Bernardo Barcellos Terra  1 , Eduardo Antônio de Figueiredo  1 , Carlos Stanislaw Fleury Marczyk  2 , Gustavo Cará Monteiro  1 , Alberto de Castro Pochini  3 , Carlos Vicente Andreoli  4 , Benno Ejnisman  5
Affiliations

OSTEOTOMIES OF THE CORACOID PROCESS: AN ANATOMICAL STUDY

Bernardo Barcellos Terra et al. Rev Bras Ortop. .

Abstract

Objective: Relate the main tendinous and ligamentous structures attached in the coracoid process, correlating it to several levels of osteotomy and describing the involved structures.

Methods: Thirty shoulders were dissected. The coracoid process with mainly inserted anatomic structures was dissected, and five levels of osteotomy (1.0; 1.5; 2.0; 2.5; 3.0 cm) were made from the apex of the process and the mainly involved structures were recorded.

Results: In osteotomies of 1.0 cm, in 100% of the cases only the conjoint tendon (CT). In osteotomies of 1.5 cm there were 63.33% of cases involved with the CT and the Pectoralis minor (PMi), in 20% of cases only the CT, and in 16.66% the CT, PMi, and the coracohumeral ligament (CUL). In osteotomies of 2.0 cm, in 80% of the shoulders, the osteotomies embraced the CT, PMi and the CUL, and in 20% only the CT and the PMi were involved. In the osteotomies of 2.5cm there was involvement of the CT, PMi and CUL in 100% of cases. In the osteotomies of 3.0cm, six cases (20%) have presented an injury on the trapezoid ligament, and in 100% of these osteotomies, the osteotomized distal fragment had embraced the CT, PMi, CUL.

Conclusion: The knowledge of anatomic structures inserted and involved in the osteotomies cuts of the coracoid process is very importan to lead with osteotomies performed in the treatment techniques of the coracoid process. Osteotomies of 3.0 cm can injure the trapezoid ligament.

Keywords: Joint Instability; Osteotomy; Shoulder Dislocation.

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Figures

Figure 1
Figure 1
Expanded deltopectoral access.
Figure 2
Figure 2
Isolated coracoid process with the anatomical structures inserted. CP: coracoid process. CT: conjoined tendon. PMi: pectoralis minor. CAL: coracoacromial ligament. Left shoulder.
Figure 3
Figure 3
Isolated coracoid process with the anatomical structures inserted. CP: coracoid process. Right shoulder.
Figure 4
Figure 4
Marking for osteotomy of 2.0cm. Right shoulder.
Figure 5
Figure 5
Simulation of osteotomy of 1.5 cm.
Figure 6
Figure 6
Graphic representation of the five levels of osteotomies.
Figure 7
Figure 7
Osteotomized distal fragment containing the conjoined tendon, pectoralis minor and coracoacromial ligament, after osteotomy of 2.0 cm.
Figure 8
Figure 8
Osteotomized distal fragment containing the conjoined tendon, pectoralis minor, coracoacromial ligament (which was pushed back) and coracohumeral ligament.
Figure 9
Figure 9
Osteotomy of 1.0 cm. In 100% of the cases, the conjoined tendon was involved.
Figure 10
Figure 10
Osteotomy of 1.5 cm. CT: conjoined tendon. PMi: Pectoralis minor. CHL: coracohumeral ligament.
Figure 11
Figure 11
Osteotomy of 2.0 cm. CT: conjoined tendon. PMi: Pectoralis minor. CHL: coracohumeral ligament.
Figure 12
Figure 12
Osteotomy of 2.5 cm. CT: conjoined tendon. PMi: Pectoralis minor. CHL: coracohumeral ligament. CAL: coracoacromial ligament.
Figure 13
Figure 13
Osteotomy of 3.0 cm. CT: conjoined tendon. PMi: Pectoralis minor. CHL: coracohumeral ligament. CAL: coracoacromial ligament. TL: trapezoid ligament.
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References

    1. Helfet AJ. Coracoid transplantation for recurring dislocation of the shoulder. J Bone Joint Surg Br. 1958;40(2):198–202. - PubMed
    1. Latarjet M. [Treatment of recurrent dislocation of the shoulder] Lyon Chir. 1954;49(8):994–997. - PubMed
    1. May VR., Jr A modified Bristow operation for anterior recurrent dislocation of the shoulder. J Bone Joint Surg Am. 1970;52(5):1010–1016. - PubMed
    1. Godinho GG, Monteiro PCVF. Tratamento cirúrgico da instabilidade anterior do ombro pela técnica de Didier-Patte. Rev Bras Ortop. 1993;28(9):640–644.
    1. Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy. 2000;16(7):677–694. - PubMed

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