Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jul 9:1:15008.
doi: 10.1038/scsandc.2015.8. eCollection 2015.

Ossification of coracoclavicular ligament in complete paraplegia: a case report

A Z Qureshi  1 , A J AlSaleh  2 , A A AlHalemi  2
Affiliations

Ossification of coracoclavicular ligament in complete paraplegia: a case report

A Z Qureshi et al. Spinal Cord Ser Cases. .

Erratum in

Abstract

Study design: A case report.

Objectives: The objective of this study was to highlight the possible etiological factors and functional implications of coracoclavicular ligament ossification in a man with paraplegia.

Setting: This study was conducted in King Fahad Medical City, Riyadh, Saudi Arabia.

Methods: A 25-year-old man was admitted as a case of complete traumatic spinal cord injury (SCI) at the T3 level for comprehensive rehabilitation after 4 months of injury. He also had a right clavicular fracture, which was managed conservatively. During his rehabilitation course, he complained of chronic right shoulder pain, which limited his activities of daily living, transfers and wheelchair mobility.

Findings: His shoulder examination was unremarkable for impingement but range of motion was restricted, which rendered the need for imaging. A computed tomography scan showed ossification of coracoclavicular ligament, illustrating a rare synostosis between the clavicle and scapula. In addition to pain management, the patient was trained on shoulder conservation techniques for performing functional tasks and showed enhanced independence in various activities of daily living.

Conclusion: SCI has an association with neurogenic heterotropic ossification (HO), which usually develops below the level of injury. A low threshold for investigating HO may be considered at fracture sites even if they are above the level of SCI, for early prevention and treatment of this disabling complication. The abnormal cross-union between the clavicle and the scapula owing to HO can alter the mechanics of the shoulder girdle along with soft tissue injuries and early degenerative changes. Formation of shoulder HO can be particularly accelerated in SCI patients due to excessive use of upper limbs and to the neurogenic nature of the injury.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CT scan of both shoulders with three-dimensional reconstruction illustrating ossification of the coracoclavicular ligament as a synostosis between the mid-clavicle and the coracoid process of the scapula. Due to this bony bridge, the scapular movements are restricted, and the clavicle and the scapula act as a one-bone unit.
See this image and copyright information in PMC

References

    1. Vernon W Lin (ed.). Spinal Cord Medicine Principles and Practice 2nd edn. Demos Medical Publishing: New York, NY, USA, 2010.
    1. Hernandez AM, Forner JV, de la Fuente T, Gonzalez C, Miro R. The para-articular ossifications on our paraplegics and tetraplegics: a survey of 704 patients. Paraplegia 1978; 16: 272–275. - PubMed
    1. van Kuijk AA, Geurts AC, van Kuppevelt HJ. Neurogenic heterotopic ossification in spinal cord injury. Spinal Cord 2002; 40: 313–326. - PubMed
    1. Damanski M. Heterotopic ossification in paraplegia: a clinical study. J Bone Joint Surg 1961; 43: 286–299.
    1. Kang SH, Park IJ, Jeong C. Suprascapular neuropathy caused by heterotropic ossification after clavicle shaft fracture: a case report. Eur J Orthop Surg Traumatol 2012; 22 (Suppl 1): S63–S66. - PubMed

LinkOut - more resources