Coracoid process fractures are relatively rare and few cases have been reported in the orthopedic literature. In this article, we report the case of an active, thirty years old, male patient with isolated, displaced f...Coracoid process fractures are relatively rare and few cases have been reported in the orthopedic literature. In this article, we report the case of an active, thirty years old, male patient with isolated, displaced fracture of the coracoid process, associated with a blunt injury to the shoulder, during a motor vehicle accident. We describe the incidence, mechanism of injury, and surgical treatment. Although rare, a high index of suspicion, special radiographic views, can detect an isolated coracoid process. Knowledge of the associated injuries will help the clinician to order further imaging and treat them accordingly. We recommend that a displaced, isolated fracture of the coracoid be treated with open reduction and osteosynthesis, to achieve early use of the extremity, good radiological union and clinical function.展开更多
Coracoid fractures are usually seen with other shoulder injuries. Isolated fractures of this prominence are rare conditions. Herein we present two isolated coracoid fractures after a motorcycle accident and a fall ont...Coracoid fractures are usually seen with other shoulder injuries. Isolated fractures of this prominence are rare conditions. Herein we present two isolated coracoid fractures after a motorcycle accident and a fall onto the shoulder respectively. Conservative treatment with sling and passive-active shoulder exercises is accepted approach in these fractures. We also prefer conservative treatment at our cases and both of them have good results.展开更多
Coracoid process of Scapula fracture is not a common entity. Because of its deep anatomic location, they hardly sustain any direct traumatic force. Most of the time, they get fractured by indirect force by the muscles...Coracoid process of Scapula fracture is not a common entity. Because of its deep anatomic location, they hardly sustain any direct traumatic force. Most of the time, they get fractured by indirect force by the muscles and ligaments attached to them. They are usually associated with fracture of the acromion process of Scapula, acromio-clavicular dislocation and proximal humerus fracture or dislocation of the shoulder joint. They may be missed because more attention is drawn by the obvious injuries. We report two cases of coracoid process fracture, one is associated with fracture dislocation of the shoulder and the other with acromion process fracture.展开更多
A fracture of the acromion and coracoid processes of scapula is rarely seen in the outpatient clinic,due to the acromion's anatomical position and shape,as well as the strong ligaments and muscles that are attache...A fracture of the acromion and coracoid processes of scapula is rarely seen in the outpatient clinic,due to the acromion's anatomical position and shape,as well as the strong ligaments and muscles that are attached to it.These fractures are caused by either direct or indirect high-energy trauma injuries to the shoulder joint,leading to severe pain and a grossly restricted range of motion.Several acromial classifications were reported,but this type of longitudinal plane fracture of the acromion process in our case is yet to be described in the current literature.We present a rare combination of the coracoid process and unstable acromion bony projection fractures that have not previously been noted for this type of fracture.The closest to this is Kuhn's type III classification.A 51-year-old male presented to our emergency department complaining of the right shoulder pain and difficulty raising his arm following a 2-wheeler accident.The patient was managed by open reduction and internal fixation with 3 cannulated cancellous screws fixation and progressed well with no postoperative complications.He was asymptomatic postoperatively and regained full range of motion after 4 months.展开更多
Purpose:Iatrogenic coracoid and clavicle fracture is a known complication of drilling bone tunnels during anatomic coracoclavicular ligament reconstruction(ACCR).This study aims to measure the dimensions of coracoid p...Purpose:Iatrogenic coracoid and clavicle fracture is a known complication of drilling bone tunnels during anatomic coracoclavicular ligament reconstruction(ACCR).This study aims to measure the dimensions of coracoid process and clavicle in an Asian population to evaluate the suitability of drilling coracoid and clavicle tunnels for ACCR in Asians.Methods:Width measurements of 196 coracoids and 189 clavicles were obtained after reviewing all computed tomography(CT)scans of the shoulder performed over a 6 years period.Coracoid measurements were made on the CT slice which showed the maximum cross sectional width of the coracoid base.Medial to lateral measurements of the coracoid width were taken on an axial view,4 mm above the identified junction of the coracoid base and glenoid base.Antero-posterior clavicle width was measured through a point directly above the midpoint of the coracoid and perpendicular to the long axis of the clavicle.Results:The overall mean coracoid width was 14.8 mm±2.54 mm(range 9.2e23.3 mm)and clavicle width was 17.1 mm±2.72 mm(range 11.1e25.3 mm).Conclusion:The Asian coracoid process is smaller than its Western equivalent.More research is required to validate this conclusion as no cadaveric studies with equivalent measurement techniques have been performed on Asians.Given the potentially narrower dimensions of the Asian coracoid process,extra precautions are required to minimize the risk of iatrogenic coracoid and clavicle fractures.展开更多
Objective: To report a new method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy. Methods: We modified Dewar’s surgical method as follows: ...Objective: To report a new method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy. Methods: We modified Dewar’s surgical method as follows: (1) Two small incisions, a transversal incision on the acromioclavicular joint and a longitudinal incision on the coracoid, were made instead of a conventional large arc incision from the acromion to coracoid. (2) The foreign body in the acromioclavicular joint was cleared out. The chondral surface at the lateral segment of clavicle was resected to form a pseudarthrosis and meanwhile the residual joint capsule and ligaments were repaired. (3) The coracoid was moved to the anteroinferior edge of the clavicle instead of the anterior margin and (4) the coracoid was moved to the lateral border of the clavicle instead of the superior border of the coracoclavicular ligament. Results: The follow up duration in 30 patients of the series was from 6 to 72 months (mean 41 months). Functional assessment was carried out by the criteria delineated previously by Karkson, in which Grade A was in 24 cases, Grade B in 4cases, and C in 2. Conclusions: This modified technique, having less postoperative complications and less injuries to tissues and according well with the requirement of biomechanics, can achieve a stable reduction of acromioclavicular joint with a good functional and cosmetic result and therefore is preferable to use clinically on a large scale.展开更多
目的比较超声引导下肋锁间隙(CCS)臂丛神经阻滞与超声引导下喙突入路锁骨下臂丛神经阻滞在前臂或手部术中临床麻醉效果。方法选取拟行前臂或手部手术患者58例,男33例,女25例,年龄18~70岁,ASAⅠ~Ⅲ级,随机分为超声引导下CCS臂丛神经阻滞...目的比较超声引导下肋锁间隙(CCS)臂丛神经阻滞与超声引导下喙突入路锁骨下臂丛神经阻滞在前臂或手部术中临床麻醉效果。方法选取拟行前臂或手部手术患者58例,男33例,女25例,年龄18~70岁,ASAⅠ~Ⅲ级,随机分为超声引导下CCS臂丛神经阻滞组(A组)和超声引导下喙突入路锁骨下臂丛神经阻滞组(B组)。分别给予0.5%罗哌卡因20 ml,记录臂丛神经深度,神经阻滞操作时间,注射局麻药后5、10、20、30 min臂丛神经分支(正中神经、尺神经、桡神经、肌皮神经)感觉阻滞和运动阻滞情况,神经阻滞持续时间,以及麻醉相关不良反应等。结果 A组臂丛神经深度(2.0±1.2)cm,明显浅于B组(3.5±1.8)cm(P<0.05);A组神经阻滞操作时间(2.0±1.5)min,明显短于B组(4.0±1.5)min(P<0.05);注射局麻药后5、10 min A组正中神经、尺神经、桡神经、肌皮神经的感觉阻滞率均明显高于B组(P<0.05);注药后10 min A组尺神经、桡神经、肌皮神经的运动阻滞率明显高于B组(P<0.05),其余时点两组运动阻滞率差异无统计学意义。两组无一例呼吸困难、恶心呕吐、耳鸣等不良反应。结论超声引导下肋锁间隙臂丛神经阻滞较喙突入路锁骨下臂丛神经阻滞深度浅,神经阻滞穿刺操作时间更短,其感觉阻滞和运动阻滞起效更快。展开更多
文摘Coracoid process fractures are relatively rare and few cases have been reported in the orthopedic literature. In this article, we report the case of an active, thirty years old, male patient with isolated, displaced fracture of the coracoid process, associated with a blunt injury to the shoulder, during a motor vehicle accident. We describe the incidence, mechanism of injury, and surgical treatment. Although rare, a high index of suspicion, special radiographic views, can detect an isolated coracoid process. Knowledge of the associated injuries will help the clinician to order further imaging and treat them accordingly. We recommend that a displaced, isolated fracture of the coracoid be treated with open reduction and osteosynthesis, to achieve early use of the extremity, good radiological union and clinical function.
文摘Coracoid fractures are usually seen with other shoulder injuries. Isolated fractures of this prominence are rare conditions. Herein we present two isolated coracoid fractures after a motorcycle accident and a fall onto the shoulder respectively. Conservative treatment with sling and passive-active shoulder exercises is accepted approach in these fractures. We also prefer conservative treatment at our cases and both of them have good results.
文摘Coracoid process of Scapula fracture is not a common entity. Because of its deep anatomic location, they hardly sustain any direct traumatic force. Most of the time, they get fractured by indirect force by the muscles and ligaments attached to them. They are usually associated with fracture of the acromion process of Scapula, acromio-clavicular dislocation and proximal humerus fracture or dislocation of the shoulder joint. They may be missed because more attention is drawn by the obvious injuries. We report two cases of coracoid process fracture, one is associated with fracture dislocation of the shoulder and the other with acromion process fracture.
文摘A fracture of the acromion and coracoid processes of scapula is rarely seen in the outpatient clinic,due to the acromion's anatomical position and shape,as well as the strong ligaments and muscles that are attached to it.These fractures are caused by either direct or indirect high-energy trauma injuries to the shoulder joint,leading to severe pain and a grossly restricted range of motion.Several acromial classifications were reported,but this type of longitudinal plane fracture of the acromion process in our case is yet to be described in the current literature.We present a rare combination of the coracoid process and unstable acromion bony projection fractures that have not previously been noted for this type of fracture.The closest to this is Kuhn's type III classification.A 51-year-old male presented to our emergency department complaining of the right shoulder pain and difficulty raising his arm following a 2-wheeler accident.The patient was managed by open reduction and internal fixation with 3 cannulated cancellous screws fixation and progressed well with no postoperative complications.He was asymptomatic postoperatively and regained full range of motion after 4 months.
文摘Purpose:Iatrogenic coracoid and clavicle fracture is a known complication of drilling bone tunnels during anatomic coracoclavicular ligament reconstruction(ACCR).This study aims to measure the dimensions of coracoid process and clavicle in an Asian population to evaluate the suitability of drilling coracoid and clavicle tunnels for ACCR in Asians.Methods:Width measurements of 196 coracoids and 189 clavicles were obtained after reviewing all computed tomography(CT)scans of the shoulder performed over a 6 years period.Coracoid measurements were made on the CT slice which showed the maximum cross sectional width of the coracoid base.Medial to lateral measurements of the coracoid width were taken on an axial view,4 mm above the identified junction of the coracoid base and glenoid base.Antero-posterior clavicle width was measured through a point directly above the midpoint of the coracoid and perpendicular to the long axis of the clavicle.Results:The overall mean coracoid width was 14.8 mm±2.54 mm(range 9.2e23.3 mm)and clavicle width was 17.1 mm±2.72 mm(range 11.1e25.3 mm).Conclusion:The Asian coracoid process is smaller than its Western equivalent.More research is required to validate this conclusion as no cadaveric studies with equivalent measurement techniques have been performed on Asians.Given the potentially narrower dimensions of the Asian coracoid process,extra precautions are required to minimize the risk of iatrogenic coracoid and clavicle fractures.
文摘Objective: To report a new method of coracoid transposition for the treatment of complete dislocation of acromioclavicular joint and to evaluate its efficacy. Methods: We modified Dewar’s surgical method as follows: (1) Two small incisions, a transversal incision on the acromioclavicular joint and a longitudinal incision on the coracoid, were made instead of a conventional large arc incision from the acromion to coracoid. (2) The foreign body in the acromioclavicular joint was cleared out. The chondral surface at the lateral segment of clavicle was resected to form a pseudarthrosis and meanwhile the residual joint capsule and ligaments were repaired. (3) The coracoid was moved to the anteroinferior edge of the clavicle instead of the anterior margin and (4) the coracoid was moved to the lateral border of the clavicle instead of the superior border of the coracoclavicular ligament. Results: The follow up duration in 30 patients of the series was from 6 to 72 months (mean 41 months). Functional assessment was carried out by the criteria delineated previously by Karkson, in which Grade A was in 24 cases, Grade B in 4cases, and C in 2. Conclusions: This modified technique, having less postoperative complications and less injuries to tissues and according well with the requirement of biomechanics, can achieve a stable reduction of acromioclavicular joint with a good functional and cosmetic result and therefore is preferable to use clinically on a large scale.
文摘目的比较超声引导下肋锁间隙(CCS)臂丛神经阻滞与超声引导下喙突入路锁骨下臂丛神经阻滞在前臂或手部术中临床麻醉效果。方法选取拟行前臂或手部手术患者58例,男33例,女25例,年龄18~70岁,ASAⅠ~Ⅲ级,随机分为超声引导下CCS臂丛神经阻滞组(A组)和超声引导下喙突入路锁骨下臂丛神经阻滞组(B组)。分别给予0.5%罗哌卡因20 ml,记录臂丛神经深度,神经阻滞操作时间,注射局麻药后5、10、20、30 min臂丛神经分支(正中神经、尺神经、桡神经、肌皮神经)感觉阻滞和运动阻滞情况,神经阻滞持续时间,以及麻醉相关不良反应等。结果 A组臂丛神经深度(2.0±1.2)cm,明显浅于B组(3.5±1.8)cm(P<0.05);A组神经阻滞操作时间(2.0±1.5)min,明显短于B组(4.0±1.5)min(P<0.05);注射局麻药后5、10 min A组正中神经、尺神经、桡神经、肌皮神经的感觉阻滞率均明显高于B组(P<0.05);注药后10 min A组尺神经、桡神经、肌皮神经的运动阻滞率明显高于B组(P<0.05),其余时点两组运动阻滞率差异无统计学意义。两组无一例呼吸困难、恶心呕吐、耳鸣等不良反应。结论超声引导下肋锁间隙臂丛神经阻滞较喙突入路锁骨下臂丛神经阻滞深度浅,神经阻滞穿刺操作时间更短,其感觉阻滞和运动阻滞起效更快。
