1
|
Xie W, Hu D, Hou H, Zheng X. Arthroscopic reduction and hollow screw internal fixation for Eyres Type IIIA scapular coracoid fracture: a case report. BMC Musculoskelet Disord 2024; 25:645. [PMID: 39148072 PMCID: PMC11325694 DOI: 10.1186/s12891-024-07767-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 08/08/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND A coracoid process fracture combined with an acromioclavicular (AC) joint dislocation is an uncommon injury that typically causes significant pain and limits shoulder movement. Open reduction and internal fixation have been the traditional treatment approach. However, arthroscopic techniques are emerging as a promising alternative for managing these injuries. CASE REPRESENTATION A 35-year-old woman presented with right shoulder pain following an accidental fall. Imaging studies revealed a coracoid process fracture along with an AC joint dislocation. The fracture was classified as an Eyres Type IIIA, which warranted surgical intervention. Our team performed arthroscopic coracoid fracture reduction and internal fixation surgery, as well as AC joint dislocation repair using Kirschner wires. Six months after surgery, the patient demonstrated a satisfactory functional outcome with complete bone healing. CONCLUSION This case report highlights the potential of arthroscopic reduction and fixation as a novel treatment option for fractures of the coracoid base.
Collapse
Affiliation(s)
- Weizhao Xie
- Department of Sports Medicine, The First Affiliated Hospital, Guangdong Provincial Key Laboratory of Speed Capability, The Guangzhou Key Laboratory of Precision Orthopedics and Regenerative Medicine, Jinan University, Guangzhou, 510630, PR China
| | - Dahai Hu
- Department of Sports Medicine, The First Affiliated Hospital, Guangdong Provincial Key Laboratory of Speed Capability, The Guangzhou Key Laboratory of Precision Orthopedics and Regenerative Medicine, Jinan University, Guangzhou, 510630, PR China.
| | - Huige Hou
- Department of Sports Medicine, The First Affiliated Hospital, Guangdong Provincial Key Laboratory of Speed Capability, The Guangzhou Key Laboratory of Precision Orthopedics and Regenerative Medicine, Jinan University, Guangzhou, 510630, PR China.
| | - Xiaofei Zheng
- Department of Sports Medicine, The First Affiliated Hospital, Guangdong Provincial Key Laboratory of Speed Capability, The Guangzhou Key Laboratory of Precision Orthopedics and Regenerative Medicine, Jinan University, Guangzhou, 510630, PR China.
| |
Collapse
|
2
|
Treadwell Smucker RE, Treadwell JA. 16-Year-Old With Anterior Shoulder Pain After a Fall While Skiing. Clin Pediatr (Phila) 2024; 63:573-575. [PMID: 37309833 DOI: 10.1177/00099228231180942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
|
3
|
Mavrotas J, Fischer J. Scapula fractures: functional anatomy, clinical assessment and management. Br J Hosp Med (Lond) 2024; 85:1-8. [PMID: 38557096 DOI: 10.12968/hmed.2023.0351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Fractures of the scapula are rare injuries, accounting for 3-5% of all shoulder girdle fractures. They are frequently the result of high energy trauma and often present with concurrent and life-threatening injuries to adjacent structures, leading to significant morbidity and mortality. Patients presenting with scapula fractures must receive a thorough and systematic clinical assessment as directed by national trauma guidelines. Appropriate imaging is essential in delineating fracture morphology and should at the very least include anteroposterior, anteroposterior oblique (Grashey) and axillary or scapula 'Y' view of the shoulder. Computed tomography imaging with three-dimensional reconstruction allows better delineation of the fracture morphology and helps with surgical planning. A lack of randomised controlled trials comparing the efficacy of conservative and operative management of scapula fractures has resulted in limited consensus for surgical indications. Nevertheless, most extra-articular fractures can be managed conservatively while intra-articular fractures of the glenoid frequently require surgical fixation.
Collapse
Affiliation(s)
- Jason Mavrotas
- Department of Orthopaedics, Macclesfield District General Hospital, East Cheshire NHS Trust, Macclesfield, UK
| | - Jochen Fischer
- Department of Orthopaedics, Macclesfield District General Hospital, East Cheshire NHS Trust, Macclesfield, UK
| |
Collapse
|
4
|
Qalib YO, Medagam SR, Dachepalli S. Ipsilateral fractures of the acromion and coracoid processes of the scapula. Chin J Traumatol 2024; 27:121-124. [PMID: 37210253 PMCID: PMC11075102 DOI: 10.1016/j.cjtee.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/28/2023] [Accepted: 03/03/2023] [Indexed: 05/22/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Yusuf Omar Qalib
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - Srinivasa Reddy Medagam
- Department of Orthopaedics, Yashoda Hospitals, Somajiguda, Hyderabad, Telangana, 500082, India
| | - Sunil Dachepalli
- Department of Orthopaedics, Yashoda Hospitals, Somajiguda, Hyderabad, Telangana, 500082, India.
| |
Collapse
|
5
|
von Rüden C, Rehme-Röhrl J, Augat P, Friederichs J, Hackl S, Stuby F, Trapp O. Evidence on treatment of clavicle fractures. Injury 2023; 54 Suppl 5:110818. [PMID: 37217399 DOI: 10.1016/j.injury.2023.05.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/24/2023]
Abstract
Depending on the severity of the injury and the involvement of the soft tissue envelope, clavicle fractures can be treated operatively or non-operatively. In the past, displaced fractures of the clavicle shaft in adults have been treated non-operatively. However, the rate of nonunion following non-operative treatment seems to be higher than previously reported. In addition, publications reporting better functional outcomes following operative treatment are increasing. In recent years this has led to a paradigm shift towards an increase of operative fracture treatment. The aim of this review article was to summarize the currently available evidence on the treatment of clavicle fractures. Classifications, indications, and treatment options for different fracture patterns of the medial, midshaft, and lateral clavicles are presented and discussed.
Collapse
Affiliation(s)
- Christian von Rüden
- Department of Trauma Surgery, Orthopaedics and Hand Surgery, Weiden Medical Center, Weiden/ Oberpfalz, Germany; Department of Trauma Surgery, BG Unfallklinik Murnau, Murnau, Germany; Institute for Biomechanics, Paracelsus Medical University, Salzburg, Austria.
| | - Julia Rehme-Röhrl
- Department of Trauma Surgery, BG Unfallklinik Murnau, Murnau, Germany
| | - Peter Augat
- Institute for Biomechanics, Paracelsus Medical University, Salzburg, Austria; Institute for Biomechanics, BG Unfallklinik Murnau, Murnau, Germany
| | - Jan Friederichs
- Department of Trauma Surgery, BG Unfallklinik Murnau, Murnau, Germany
| | - Simon Hackl
- Department of Trauma Surgery, BG Unfallklinik Murnau, Murnau, Germany; Institute for Biomechanics, Paracelsus Medical University, Salzburg, Austria
| | - Fabian Stuby
- Department of Trauma Surgery, BG Unfallklinik Murnau, Murnau, Germany
| | - Oliver Trapp
- Department of Trauma Surgery, BG Unfallklinik Murnau, Murnau, Germany
| |
Collapse
|
6
|
Lollino N, Coltella L. The X-Mas Box Osteosuture: A New Technique for Coracoid Process Fracture. Tech Hand Up Extrem Surg 2023; 27:148-150. [PMID: 36745748 DOI: 10.1097/bth.0000000000000427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A fracture of the tip of the coracoid is a rare but challenging fracture. A surgical indication is required in case of a displaced fracture. Screws and suture anchors often do not offer a reliable fixation in the case of very small fragments. We describe our hardwareless technique that consists of an osteosuture with a 90-degree suture threads configuration that we called the x-mas box technique. This procedure is cost-effective and it provides stable fixation and low complications rate.
Collapse
Affiliation(s)
- Nicola Lollino
- Department of Orthopedic, O. Civile Edoardo Agnelli di Pinerolo, Università degli Studi di Torino, Roma, Italy
| | | |
Collapse
|
7
|
Tuor P, Dietrich M, Grüninger P. Surgical management of multiple superior shoulder suspensory complex disruptions involving at least a coracoid fracture and an acromioclavicular dislocation: A report of five cases. SAGE Open Med Case Rep 2023; 11:2050313X231166776. [PMID: 37122423 PMCID: PMC10134166 DOI: 10.1177/2050313x231166776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/14/2023] [Indexed: 05/02/2023] Open
Abstract
A combination of coracoid fracture and acromioclavicular dislocation is rare. Detecting further pathologies that could cause multiple superior shoulder suspensory complex disruptions is mandatory. Literature regarding these injuries and their management is lacking. We report our diagnostic and surgical strategies, and the postoperative outcomes of superior shoulder suspensory complex disruptions. We present five cases, treated from 2011 to 2016, who had >2 disruptions of the superior shoulder suspensory complex, involving at least a coracoid fracture and an acromioclavicular joint dislocation. Surgical reconstruction was performed in all cases. The patients were postoperatively followed up for a year. There were no intraoperative or postoperative complications, and bone union was achieved in all fractures. Furthermore, all patients returned to their pre-surgery activity level and jobs. Thus, we could demonstrate that in multiple superior shoulder suspensory complex disruptions involving a coracoid fracture and an acromioclavicular joint dislocation, surgical treatment leads to a good functional outcome.
Collapse
Affiliation(s)
- Philipp Tuor
- Department of Orthopedic Surgery, Handsurgery and Traumatology at City Hospital Waid and Triemli, Zurich, Switzerland
- Philipp Tuor, Department of Orthopedic Surgery, Handsurgery and Traumatology at City Hospital Waid and Triemli, Tièchestrasse 99, Zurich 8037, Switzerland.
| | - Michael Dietrich
- Department of Orthopedic Surgery, Handsurgery and Traumatology at City Hospital Waid and Triemli, Zurich, Switzerland
| | | |
Collapse
|
8
|
Baren JP, Rowbotham E, Robinson P. Acromioclavicular Joint Injury and Repair. Semin Musculoskelet Radiol 2022; 26:597-610. [DOI: 10.1055/s-0042-1750726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AbstractThe acromioclavicular (AC) joint is commonly injured in athletes participating in contact and overhead throwing sports. Injuries range from simple sprains to complete ligamentous disruption, and they are classified by the established Rockwood grading system. High-grade injuries are associated with fractures around the AC joint and disruption of the superior shoulder suspensory complex, a ring of osseous and ligamentous structures at the superior aspect of the shoulder. Radiographs are the mainstay of imaging of the AC joint, with magnetic resonance imaging reserved for high-grade injuries to aid classification and plan surgical management. Low-grade AC joint injuries tend to be managed conservatively, but a wide range of surgical procedures have been described for higher grade injuries and fractures around the AC joint. This review illustrates the anatomy of the AC joint and surrounding structures, the imaging features of AC joint injury, and the most commonly performed methods of reconstruction and their complications.
Collapse
Affiliation(s)
- James P. Baren
- Department of Musculoskeletal Radiology, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Emma Rowbotham
- Department of Musculoskeletal Radiology, Leeds Teaching Hospitals, Leeds, United Kingdom
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, University of Leeds, Leeds, United Kingdom
| | - Philip Robinson
- Department of Musculoskeletal Radiology, Leeds Teaching Hospitals, Leeds, United Kingdom
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, University of Leeds, Leeds, United Kingdom
| |
Collapse
|
9
|
Gulcu A. Coracoid fracture caused by lifting a heavy object: a rare clinical presentation. Acta Orthop Belg 2022; 88:513-516. [PMID: 36791704 DOI: 10.52628/88.3.8647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The purpose of this narrative review was to highlight the research on the influence of weather conditions on patients with osteoarthritis, the pathophysiological mechanisms and the therapeutic consequences. A search was conducted using the Pubmed, Medline and Web of Science databases. Barometric pressure, temperature and humidity are the weather conditions that are found to be correlated most to the worsening of pain complaints. But, due to the difficulty of measuring the impact of these variables and the great diversity in study protocols, an analysis of studies regarding this topic shows conflicting results. Central sensitization mechanisms and the function of a Transient Receptor Potential channel might explain the pain hypersensitivity to cold weather. Joint pain, caused by central sensitization mechanisms, cannot always be treated with joint arthroplasty. When pain remains present after joint arthroplasty, centrally mediated pain constitutes an important role.
Collapse
|
10
|
Presumed Glenoid SLAP Tear in an Adolescent Football Player Belied the Presence of a Coracoid Growth Plate Fracture: A Diagnostic Conundrum. Case Rep Orthop 2022; 2022:1756611. [PMID: 35154839 PMCID: PMC8828351 DOI: 10.1155/2022/1756611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/03/2022] [Indexed: 11/17/2022] Open
Abstract
We report the case of a 13-year-old male who sustained a right shoulder injury while playing quarterback in an American football game. A noncontrast MRI scan showed evidence of a possible grade 1 SLAP tear (SLAP = superior labral anterior-posterior), and surgery was recommended. However, at the preoperative visit, the surgeon was suspicious that the main source of pain had been missed. Bilateral shoulder radiographs taken for comparative analysis revealed a Salter-Harris type I coracoid growth-plate fracture. Therefore, the surgeon planned to manage the patient nonoperatively and postponed the proposed SLAP tear surgery. The patient was instructed to cease participation in athletic events and undergo physical therapy. Hoping to expedite his healing with platelet or stem cell injections, the parents sought an opinion from another physician who obtained a right shoulder MRI with intra-articular contrast. This confirmed that there was no SLAP tear. We concluded that the patient initially had glenohumeral and coracoclavicular ligament strains and a coracoid growth-plate fracture. The SLAP tear suggested by the initial MRI proved to be a red herring, belying an accurate diagnosis. The patient ultimately recovered fully with physical therapy and without surgery or other interventions.
Collapse
|
11
|
Doğar F, Dere Kİ, Gürbüz K, Topak D, Özdemir MA, Kuşcu B, Bilal Ö. Rare coracoid fractures presenting with superior shoulder suspensory complex injury: A case series. Jt Dis Relat Surg 2021; 32:804-809. [PMID: 34842118 PMCID: PMC8650649 DOI: 10.52312/jdrs.2021.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/18/2021] [Indexed: 11/14/2022] Open
Abstract
Although coracoid fractures are rare fractures, their treatment is critical as they form the coracoacromial arch and superior shoulder suspensory complex (SSSC), which are important structures for shoulder biomechanics. In this case series, clinical, radiological, and demographic characteristics of three male patients who received treatment due to coracoid fracture presenting with traumatic injuries were discussed. The fractures were classified according to the Ogawa and Eyres classifications, and fracture fixation was achieved surgically with the cannulated screws. All patients had a right coracoid fracture. The Constant-Murley Score and the Disabilities of the Arm, Shoulder and Hand scores the patients in the final follow-up visit at 12 months were calculated. In conclusion, good clinical and functional outcomes can be achieved by anatomical reduction and fixation through surgery for displaced coracoid fractures presenting with multiple traumatic injuries located in multiple regions of the SSSC.
Collapse
Affiliation(s)
- Fatih Doğar
- Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 46040 Onikişubat, Kahramanmaraş, Türkiye.
| | | | | | | | | | | | | |
Collapse
|
12
|
Ben-Ari E, Pines Y, Gordon D, Zuckerman JD, Petchprapa C, Virk MS. Radiographic and clinical characterization of coracoid fractures: a retrospective cohort analysis. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2021; 32:1601-1607. [PMID: 34628533 DOI: 10.1007/s00590-021-03144-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/04/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Coracoid fracture is a rare injury. The aim of this study is to present the demographics, clinical and radiologic characteristics, and outcomes of coracoid fracture in a cohort of 32 patients. METHODS We queried our institutional electronic medical record database (years 2012-2020) to identify patients with coracoid fractures using specific International Classification of Disease-10 codes. Demographic data, injury details including mechanism of injury and associated injuries, imaging performed, and treatment outcomes were obtained from retrospective chart review. A radiologist reviewed all available imaging studies (radiographs/CT/MRI) and classified the fractures according to Ogawa and Eyres classifications. Missed diagnoses were determined by comparing initial imaging reports with the follow-up imaging obtained in the office. RESULTS Thirty-two patients with coracoid fractures were identified during the study period. Sixteen fractures (50%) occurred in the setting of low-energy trauma. Twelve fractures were missed on initial radiographs, and diagnosis with three-view radiographs (AP, scapular-Y and axillary) was 88% compared to 33% (p < 0.03) with two views (AP, scapular-Y). The majority of fractures were non-displaced (94%), and 56% were Ogawa Type-II fractures. Associated injuries were seen in 81% of patients. Most fractures (94%) were treated without surgery with excellent outcomes. CONCLUSION Coracoid fractures continue to be a rare injury. In contrast to previous studies, in this case series of 32 patients, half of the fractures were associated with low-energy trauma, which correlated with higher percentage of non-displaced fractures and Ogawa Type-II fractures. Addition of the axillary view in the trauma radiographic series significantly improved the initial fracture detection rate. LEVEL IV Retrospective study.
Collapse
Affiliation(s)
- Erel Ben-Ari
- Department of Orthopaedic Surgery, Division of Shoulder and Elbow, New York University Langone Health, New York, NY, USA. .,Division of Orthopaedic Surgery, Tel-Hashomer "Sheba" Medical Center, Sackler School of Medicine, Tel-Aviv University, Ramat Gan, Israel.
| | - Yaniv Pines
- Department of Orthopaedic Surgery, Division of Shoulder and Elbow, New York University Langone Health, New York, NY, USA
| | - Dan Gordon
- Department of Orthopaedic Surgery, Division of Shoulder and Elbow, New York University Langone Health, New York, NY, USA
| | - Joseph D Zuckerman
- Department of Orthopaedic Surgery, Division of Shoulder and Elbow, New York University Langone Health, New York, NY, USA
| | - Catherine Petchprapa
- Division of Radiology, Musculoskeletal Imaging, New York University Langone Health, New York, NY, USA
| | - Mandeep S Virk
- Department of Orthopaedic Surgery, Division of Shoulder and Elbow, New York University Langone Health, New York, NY, USA
| |
Collapse
|
13
|
Sun Z, Li H, Wang B, Yan J, Han L, Han S, Yang X, Zhao B. A guideline for screw fixation of coracoid process base fracture by 3D simulation. J Orthop Surg Res 2021; 16:58. [PMID: 33446228 PMCID: PMC7809839 DOI: 10.1186/s13018-021-02203-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fractures of the base of the coracoid process are relatively rare, but an increasing number of studies have reported using screws to fix coracoid process base fractures. This study was performed to simulate the surgical procedure and obtain the ideal diameter, length, insertion point and angle of the screw from a 3-D axial perspective in Chinese patients. METHODS We randomly collected right scapula computed tomography (CT) scans from 100 adults. DICOM-formatted CT scan images were imported into Mimics software. A 3D digital model of the right scapula was established. Two virtual cylinders representing two screws were placed from the top of the coracoid process to the neck of the scapula and across the base of the coracoid process to fix the base of the coracoid process. The largest secure diameters and lengths of the virtual screws were measured. The positions of the insertion points and the directions of the screws were also examined. RESULTS The screw insertion safe zone can exhibit an irregular fusiform shape according to the reconstructed scapula model. The mean maximum diameters of the medial and lateral screws were 7.08 ± 1.19 mm and 7.34 ± 1.11 mm, respectively. The mean maximum lengths of the medial and lateral screws were 43.11 ± 6.31 mm and 48.16 ± 6.94 mm, respectively. A screw insertion corridor with a diameter of at least 4.5 mm was found in all patients. We found sex-dependent differences in the mean maximum diameters and maximum lengths of the two screws. The positions of the two insertion points were statistically different across sexes. CONCLUSIONS The study provides a valuable guideline for determining the largest secure corridor for two screws in fixing a fracture at the base of the coracoid process. For ideal screw placement, we suggest individualised preoperative 3D reconstruction simulations. Further biomechanical studies are needed to verify the function of the screws.
Collapse
Affiliation(s)
- Zhongye Sun
- Department of Orthopaedics, Liaocheng People’s Hospital, 67 Dongchang West Road, Liaocheng, 252000 Shandong China
| | - Hao Li
- Department of Orthopaedics, Liaocheng People’s Hospital, 67 Dongchang West Road, Liaocheng, 252000 Shandong China
| | - Bei Wang
- Department of Imaging, Liaocheng Infectious Disease Hospital, Liaocheng, Shandong China
| | - Jun Yan
- Department of Orthopaedics, Liaocheng People’s Hospital, 67 Dongchang West Road, Liaocheng, 252000 Shandong China
| | - Liren Han
- Department of Orthopaedics, Liaocheng People’s Hospital, 67 Dongchang West Road, Liaocheng, 252000 Shandong China
| | - Shizhang Han
- Department of Orthopaedics, Liaocheng People’s Hospital, 67 Dongchang West Road, Liaocheng, 252000 Shandong China
| | - Xiaofei Yang
- Department of Orthopaedics, Liaocheng People’s Hospital, 67 Dongchang West Road, Liaocheng, 252000 Shandong China
| | - Bei Zhao
- Department of Orthopaedics, Liaocheng People’s Hospital, 67 Dongchang West Road, Liaocheng, 252000 Shandong China
| |
Collapse
|