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Avulsion fracture of the coracoid process in a patient with chronic anterior shoulder instability treated with the Latarjet procedure: a case report.

Schneider MM, Balke M, Koenen P, Bouillon B, Banerjee M - J Med Case Rep (2014)

Bottom Line: He was able to return to his job.We opted for a coracoid transfer and achieved an optimal reconstruction, as shown on the postoperative computed tomography scan.An avulsion fracture of the coracoid process with dislocation of the conjoined tendons can not only be found in patients suffering a direct trauma as pointed out in the literature, but also in patients with anterior shoulder instability with recurrent anterior shoulder dislocation.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Traumatology and Sports Medicine, Cologne-Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Str, 200, D-51109 Cologne, Germany. marco.schneider@orthopia.com.

ABSTRACT

Introduction: Shoulder dislocations can cause acute and chronic instabilities that need to be addressed in order to restore joint functioning. The transfer of the coracoid process has become a feasible surgical procedure in patients with shoulder instability. Several concomitant injuries after recurrent dislocations have been described.

Case presentation: A 32-year-old German man presented to our department with a history of recurrent shoulder dislocations. He was diagnosed with an avulsion fracture of the coracoid process and dislocation of an osseous piece with attachment to the conjoined tendons during the surgical transfer of the coracoid process. Therefore, we performed an open Latarjet procedure and reattached the bony piece with the conjoined tendons to the glenoid rim. Three months after the operation the patient presented with a satisfying range of motion and without instabilities or pain. He was able to return to his job.

Conclusions: Patients suffering from anterior shoulder dislocation might develop accompanying lesions after numerous dislocations that are not present upon first visit. Different techniques for the reconstruction of the glenoid rim and the restoration of shoulder joint stability have been described in the literature. We opted for a coracoid transfer and achieved an optimal reconstruction, as shown on the postoperative computed tomography scan. An avulsion fracture of the coracoid process with dislocation of the conjoined tendons can not only be found in patients suffering a direct trauma as pointed out in the literature, but also in patients with anterior shoulder instability with recurrent anterior shoulder dislocation.

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Three-month follow-up computed tomography scan with timely ossification of the attached bone piece.
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Fig7: Three-month follow-up computed tomography scan with timely ossification of the attached bone piece.

Mentions: On his follow-up visit three months after the intervention he presented with a satisfying range of motion and without pain (140° anteversion, 120° abduction, 40° external rotation). All instability tests were negative. A repeated CT scan showed a timely ossification of the fixed bony piece (Figure 7). Therefore, full weight bearing was allowed and he was motivated to return to his job.Figure 4


Avulsion fracture of the coracoid process in a patient with chronic anterior shoulder instability treated with the Latarjet procedure: a case report.

Schneider MM, Balke M, Koenen P, Bouillon B, Banerjee M - J Med Case Rep (2014)

Three-month follow-up computed tomography scan with timely ossification of the attached bone piece.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4265481&req=5

Fig7: Three-month follow-up computed tomography scan with timely ossification of the attached bone piece.
Mentions: On his follow-up visit three months after the intervention he presented with a satisfying range of motion and without pain (140° anteversion, 120° abduction, 40° external rotation). All instability tests were negative. A repeated CT scan showed a timely ossification of the fixed bony piece (Figure 7). Therefore, full weight bearing was allowed and he was motivated to return to his job.Figure 4

Bottom Line: He was able to return to his job.We opted for a coracoid transfer and achieved an optimal reconstruction, as shown on the postoperative computed tomography scan.An avulsion fracture of the coracoid process with dislocation of the conjoined tendons can not only be found in patients suffering a direct trauma as pointed out in the literature, but also in patients with anterior shoulder instability with recurrent anterior shoulder dislocation.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Traumatology and Sports Medicine, Cologne-Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Str, 200, D-51109 Cologne, Germany. marco.schneider@orthopia.com.

ABSTRACT

Introduction: Shoulder dislocations can cause acute and chronic instabilities that need to be addressed in order to restore joint functioning. The transfer of the coracoid process has become a feasible surgical procedure in patients with shoulder instability. Several concomitant injuries after recurrent dislocations have been described.

Case presentation: A 32-year-old German man presented to our department with a history of recurrent shoulder dislocations. He was diagnosed with an avulsion fracture of the coracoid process and dislocation of an osseous piece with attachment to the conjoined tendons during the surgical transfer of the coracoid process. Therefore, we performed an open Latarjet procedure and reattached the bony piece with the conjoined tendons to the glenoid rim. Three months after the operation the patient presented with a satisfying range of motion and without instabilities or pain. He was able to return to his job.

Conclusions: Patients suffering from anterior shoulder dislocation might develop accompanying lesions after numerous dislocations that are not present upon first visit. Different techniques for the reconstruction of the glenoid rim and the restoration of shoulder joint stability have been described in the literature. We opted for a coracoid transfer and achieved an optimal reconstruction, as shown on the postoperative computed tomography scan. An avulsion fracture of the coracoid process with dislocation of the conjoined tendons can not only be found in patients suffering a direct trauma as pointed out in the literature, but also in patients with anterior shoulder instability with recurrent anterior shoulder dislocation.

Show MeSH
Related in: MedlinePlus