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Zou Y, Di W. Robot-assisted close reduction with double screw fixation for the coracoid-process base fracture: A case report. Asian J Surg 2024; 47:1793-1794. [PMID: 38160148 DOI: 10.1016/j.asjsur.2023.12.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024] Open
Affiliation(s)
| | - Wenfei Di
- Department of Orthopedics, Gansu Provincial Hospital, Lanzhou, 730000, China.
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Ye CX, Guo YB, Zheng YH, Wu ZB, Chen KY, Zhang XL, Chen ZM. Treatment of coracoid process fractures combined with acromioclavicular joint dislocation using clavicular hook plate. J Shoulder Elbow Surg 2023; 32:e548-e555. [PMID: 37263479 DOI: 10.1016/j.jse.2023.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND The injury mechanism of acromioclavicular (AC) dislocation combined with coracoid process (CP) fracture is not clear, and there is no consensus on its treatment. This study was performed to evaluate the diagnosis of CP fractures combined with AC dislocation and the effectiveness of operative treatment using a clavicular hook plate. METHODS Eighteen patients with CP fractures combined with AC dislocation were treated with a clavicular hook plate from May 2012 to June 2021. The patients comprised 10 male and 8 female patients with an average age of 38 years (range, 16-54 years). The injury was caused by falling in 15 patients, traffic accidents in 2 patients, and falling from a height in 1 patient. The Eyres type of CP fracture was type II in 1 patient, type III in 11 patients, type IV in 3 patients, and type V in 3 patients. The Ogawa type of CP fracture was type I in 17 patients and type II in 1 patient. The Rockwood type of AC dislocation was type V in 1 patient, variation type III in 15 patients, and variation type V in 2 patients. The interval from injury to the operation was 3 days (range, 1-7 days). Postoperative complications and CP fracture healing were recorded. Functional assessment at the last follow-up was performed by an independent reviewer using the Constant score and visual analog scale score. RESULTS All 18 patients were followed up for a mean period of 49 months (range, 12-123 months). Nine patients had acromion osteolysis and 3 patients had CP fracture nonunion (Eyres type II, III, and V in 1 patient each); however, no patients developed shoulder pain, incision infection, limitation of shoulder movement, clinical symptoms of subcoracoid impingement, or AC dislocation relapse. At the last follow-up, the mean Constant score was 99 (range, 94-100). CONCLUSIONS The possibility of CP fracture should be considered in patients with AC dislocation to avoid a missed diagnosis. Fixation with a clavicular hook plate is a feasible treatment for CP fracture combined with AC dislocation and provides a satisfactory outcome. CP fracture healing may be related to the fracture morphology.
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Affiliation(s)
- Chun-Xiao Ye
- Upper Extremity Service, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian, China
| | - Ying-Bin Guo
- Upper Extremity Service, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian, China.
| | - You-Hui Zheng
- Upper Extremity Service, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian, China
| | - Zhen-Bin Wu
- Medical Imaging Department, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian, China
| | - Kai-Yu Chen
- Upper Extremity Service, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian, China
| | - Xiao-Ling Zhang
- Upper Extremity Service, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian, China
| | - Zhi-Ming Chen
- Upper Extremity Service, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian, China
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Ševčík M, Uhrin T, Vidovič D. Anterior Shoulder Dislocation with Concomitant Fracture of processus coracoideus and tuberculum majus humeri - Case Report. Acta Chir Orthop Traumatol Cech 2022; 89:380-383. [PMID: 36322040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Glenohumeral joint is the most frequently dislocated joint of the human body. Concomitant fractures of the coracoid process and tuberculum majus in humeral dislocation of the shoulder joint are rarely described. Concomitant fractures are results of a significant contraction of the surrounding muscles and rotator cuff during a cerebral paroxysm. Due to the small number of cases, the treatment of such injuries is not simple and it is based on an algorithm for treatment of isolated injuries of these anatomical structures. In this case report, we describe a concomitant fracture of the coracoid process and tuberculum majus during an anterior shoulder dislocation in 25-year-old patient after an epileptic seizure. The injury was treated in our department surgically, with a good functional result. The absolute Constant score for the operated arm is 95 points, the relative Constant score is 97%, DASH score 0, VAS score 0.
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Affiliation(s)
- M Ševčík
- Orthopaedic department, Hospital Agel Skalica, Slovakia
| | - T Uhrin
- Orthopaedic department, Hospital Agel Skalica, Slovakia
| | - D Vidovič
- Orthopaedic department, Hospital Agel Skalica, Slovakia
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Abstract
INTRODUCTION Although the coracoid process seems to play an important anatomical role, there are few reports concerning fracture nonunion of the coracoid process (CN) and its disorders. Therefore, there is no widely accepted standard for the treatment of CN. MATERIALS AND METHODS PubMed and Scopus were searched using "scapular fracture" and "coracoid fracture" as search terms. The inclusion criteria were English full-text articles concerning coracoid fracture, and articles that described patient characteristics and presented appropriate images. The exclusion criteria were descriptive cases, and cases without appropriate images. Citation tracking was conducted to find additional articles and notable full-text articles written in other languages. Fractures were classified using Ogawa's functional classification, with Eyres' anatomical classification used as a supplement when necessary. RESULTS Twenty-nine patients (26 men, 3 women) with 30 CN were identified. Nine CN had a predisposing factor such as seizure disorder and renal osteodystrophy. The fracture types were 12 Ogawa type I and 18 type II. Concurrent shoulder girdle injuries at the time of initial trauma/accident were varied. There were six cases of double disruption and two of triple disruption of the superior shoulder suspensory complex (SSSC), all of which had Ogawa type I fracture. Only six CN were isolated. The most frequent cause of CN was oversight by the previous physician (n = 11), followed by conservative treatment (n = 7). Although 12 patients with 13 CN had symptoms attributable to CN, most of these symptoms were insignificant. Although the acromioclavicular dislocation or CN persisted in eight patients, these residual abnormalities did not significantly affect the outcomes. CONCLUSIONS Physicians treating CN should recognize that CN itself is frequently asymptomatic, and a satisfactory outcome is achieved solely by treating the concurrent injuries, even if CN remains. When CN is suspected to produce symptoms, the physician must then determine the mechanism by which the symptoms are produced, and select a treatment strategy. LEVEL OF EVIDENCE V.
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Affiliation(s)
- Kiyohisa Ogawa
- Department of Orthopedic Surgery, Eiju General Hospital, 2-23-16 Higashi-Ueno, Taito-ku, Tokyo, 110-8645, Japan.
| | - Noboru Matsumura
- Department of Orthopedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Atsushi Yoshida
- Department of Orthopedic Surgery, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako, Saitama, 351-0102, Japan
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Bender MJ, Morris BJ, Laughlin MS, Sheth MM, Budeyri A, Le RK, Elkousy HA, Edwards TB. Early Complication Rates Following Total Shoulder Arthroplasty for Instability Arthropathy With a Prior Coracoid Transfer Procedure. Orthopedics 2021; 44:e482-e486. [PMID: 34292829 DOI: 10.3928/01477447-20210618-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to report early complications for anatomic total shoulder arthroplasty (aTSA) performed for instability arthropathy after a prior coracoid transfer procedure and compare them with those of a control group of patients following aTSA for primary osteoarthritis. A retrospective review was performed of 14 patients after aTSA with a prior coracoid transfer procedure. A control group of 42 patients with an aTSA for primary osteoarthritis were matched 3:1 according to age, sex, body mass index, comorbidities, and dominant shoulder. Chart reviews identified any complications within 1 year, in addition to blood loss and operative time in both groups. Preoperative computed tomography scans were used to determine Walch glenoid classification and Goutallier classification of the subscapularis. The mean operative time was not significantly different between the coracoid transfer cohort and the control group, and the mean estimated blood loss was only 6.9 mL greater in the coracoid transfer group. The coracoid transfer group had 2 (14.3%) patients with complications, with 1 early revision for an acute deep infection. The control group had 4 (9.5%) complications in 3 (7.1%) patients, with no early revisions. There was no statistical difference in complications between the groups (P=.618). Anatomic TSA for instability arthropathy after coracoid transfer had similar operative time, blood loss, and 1-year complication rates as those of the control group. These results provide some evidence to support the continued use of aTSA in select patients with instability arthropathy after prior coracoid transfer procedure. [Orthopedics. 2021;44(4):e482-e486.].
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Liau GZQ, Phua SKA, Li T, Yap KY, Teo RWL, Manohara R. Concomitant fracture of the coracoid process following acromioclavicular joint dislocation. Ann Acad Med Singap 2021; 50:438-440. [PMID: 34100522 DOI: 10.47102/annals-acadmedsg.2020328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Fradet J, Losson A, Koneazny C, Vendeuvre T. An innovative fixation technique by osteosuture in a young athletic female patient with coracoid process fracture: a case report. Pan Afr Med J 2021; 40:218. [PMID: 35136481 PMCID: PMC8783312 DOI: 10.11604/pamj.2021.40.218.30731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/25/2021] [Indexed: 11/11/2022] Open
Abstract
Coracoid process fractures are uncommon lesions but are frequently associated with an acromioclavicular dislocation. The aim of this article is to report our experience of an innovative fixation technique by osteosuture in a young athletic female patient presenting a displaced fracture of the coracoid process on the insertion footprint of coracoclavicular ligaments, with no breach of continuity of the lower coracoid cortex. She also had a roockwood type 3 acromioclavicular dislocation. After a deltopectoral approach, the fracture was reduced to the anatomical position and stabilized by a first lacing, using a non-absorbable large caliber thread passing under the mid part of the coracoid process between the 2 coracoclavicular ligaments. A second lacing passing under the coracoid process and through the trapezoid ligament, and a third one through the conoïd ligament. At 6 months, the fracture was consolidated and the constant score was 100/100. This innovative fixation provides good clinical and radiological results in the short and medium term.
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Affiliation(s)
- Juliette Fradet
- Department of Orthopaedic Surgery, Orthopaedic Unit, University Hospital Poitiers, Paris, France
- Corresponding author: Juliette Fradet, Department of Orthopaedic Surgery, Orthopaedic Unit, University Hospital Poitiers, Paris, France.
| | - Alexandre Losson
- Department of Orthopaedic Surgery, Orthopaedic Unit, University Hospital Poitiers, Paris, France
| | - Christopher Koneazny
- Department of Orthopaedic Surgery, Orthopaedic Unit, University Hospital Poitiers, Paris, France
| | - Tanguy Vendeuvre
- Department of Orthopaedic Surgery, Orthopaedic Unit, University Hospital Poitiers, Paris, France
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Wollstein J, Tegtbur U, Meller R, Hanke AA, Berndt T, Krettek C, Weber-Spickschen TS. [Isolated fracture of the coracoid process in a 14-year-old national water polo player : Case example]. Unfallchirurg 2019; 122:79-82. [PMID: 30167719 DOI: 10.1007/s00113-018-0547-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Isolated fractures of the coracoid process during sporting activities are very rare. There are a few case studies and retrospective studies with low numbers of cases. OBJECTIVE Presentation of an initially neglected fracture and conservative treatment. METHODS Case study of a 14-year-old national water polo player with a non-dislocated fracture of the coracoid process and conservative therapy using focused shockwave therapy. RESULT Return to sports after conservative therapy was after 13 weeks and return to competitive sport after 14 weeks. CONCLUSION In cases with therapy refractory shoulder pain after trauma and unremarkable native X‑ray, extended 3D imaging by magnetic resonance imaging (MRI) or computed tomography (CT) should be done early. Conservative therapy of a non-dislocated fracture in this case showed a good outcome.
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Affiliation(s)
- Johannes Wollstein
- Institut für Sportmedizin, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Deutschland.
- Klinik für Orthopädie, Unfallchirurgie, Sportmedizin, Agnes Karll Krankenhaus Laatzen, Hildesheimer Str. 158, 30880, Laatzen, Deutschland.
| | - Uwe Tegtbur
- Institut für Sportmedizin, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Deutschland
| | - Rupert Meller
- Klinik für Unfallchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Alexander A Hanke
- Institut für Sportmedizin, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Deutschland
| | - Thomas Berndt
- Klinik für Orthopädie, Unfallchirurgie, Sportmedizin, Agnes Karll Krankenhaus Laatzen, Hildesheimer Str. 158, 30880, Laatzen, Deutschland
| | - Christian Krettek
- Klinik für Unfallchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Thomas S Weber-Spickschen
- Institut für Sportmedizin, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Deutschland
- Klinik für Unfallchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
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Lo IK, Matthewson G. Editorial Commentary: Working Around the Coracoid-The Lighthouse to the Shoulder. Arthroscopy 2019; 35:380-381. [PMID: 30712618 DOI: 10.1016/j.arthro.2018.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 11/05/2018] [Indexed: 02/02/2023]
Abstract
Working around the coracoid has now become commonplace in arthroscopic shoulder surgery. No longer is there a safe side and a "suicide"; therefore, it is important to recognize the potential for neurovascular injury when surgery is performed about the coracoid. Although safe zones and distances are important, when more complex procedures are performed arthroscopically, direct visualization and identification of neurovascular structures is critical in avoiding iatrogenic injury.
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Yukata K, Goto T, Sakai T, Fujii H, Hamawaki J, Yasui N. Ultrasound-guided coracohumeral ligament release. Orthop Traumatol Surg Res 2018; 104:823-827. [PMID: 29567320 DOI: 10.1016/j.otsr.2018.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 11/13/2017] [Accepted: 01/17/2018] [Indexed: 02/02/2023]
Abstract
Long-term follow-up of patients with adhesive capsulitis (AC) reveals that approximately half of them suffer from a limited range of shoulder motion, particularly external and/or internal rotation. We report the surgical technique and short-term clinical outcomes of ultrasound-guided release of the thickened coracohumeral (CH) ligament in 8 patients (9 shoulders) with AC. Passive external rotation with the arm by the side significantly increased from an average of 18° preoperatively to 47° immediately after CH ligament release. VAS and ASES scores were improved at 3months follow-up in all 9 shoulders, and maintained at 6months follow-up in 6 shoulders. No procedure-related adverse events developed over the 6-month follow-up period. Ultrasound-guided release for thickened CH ligament is a reliable and effective minimally invasive surgery for persistent limited external rotation due to AC of the shoulder.
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Affiliation(s)
- K Yukata
- Department of Orthopedics, Tokushima University Hospital, 3-18-15 Kuramoto, 770-8503 Tokushima, Japan; Department of Orthopedic Surgery, Hamawaki Orthopaedic Hospital, 4-6-6 Otemachi Naka-ku, 730-0051 Hiroshima, Japan; Department of Orthopedic Surgery, Ogori Daiichi General Hospital, 862-3 Ogori-Shimogo, 754-0002 Yamaguchi, Japan.
| | - T Goto
- Department of Orthopedics, Tokushima University Hospital, 3-18-15 Kuramoto, 770-8503 Tokushima, Japan.
| | - T Sakai
- Department of Orthopedics, Tokushima University Hospital, 3-18-15 Kuramoto, 770-8503 Tokushima, Japan.
| | - H Fujii
- Department of Orthopedic Surgery, Ogori Daiichi General Hospital, 862-3 Ogori-Shimogo, 754-0002 Yamaguchi, Japan.
| | - J Hamawaki
- Department of Orthopedic Surgery, Hamawaki Orthopaedic Hospital, 4-6-6 Otemachi Naka-ku, 730-0051 Hiroshima, Japan.
| | - N Yasui
- Department of Orthopedics, Tokushima University Hospital, 3-18-15 Kuramoto, 770-8503 Tokushima, Japan.
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Kartus JT. Editorial Commentary: Drilling Is Never Easy Nor Without Danger in the Shoulder Region. Arthroscopy 2018; 34:2018. [PMID: 29976421 DOI: 10.1016/j.arthro.2018.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 02/07/2018] [Indexed: 02/02/2023]
Abstract
Drilling anatomic tunnels when performing coracoclavicular reconstruction might jeopardize the medial cortex of the coracoid process.
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Abstract
RATIONALE Osteosarcomas are the most common primary malignant bone tumors in children and young adults; these tumors often affect the metaphyses of long bones such as the proximal humerus, proximal tibia, and distal femur. In contrast, osteosarcoma of the coracoid process is extremely rare. PATIENT CONCERNS Herein, we describe a case of osteosarcoma affecting the coracoid process in a 40-year-old woman. The patient presented with shoulder pain, weakness, and an inability to raise her left arm. She had no previous record of shoulder injury and no significant family history. DIAGNOSES Her C-reactive protein levels were normal, whereas her erythrocyte sedimentation rate and alkaline phosphatase levels were elevated. Imaging studies led to the initial diagnosis of osteochondroma. INTERVENTION The patient underwent surgical resection. However, the postoperative pathological results revealed an osteosarcoma. The patient transferred to another hospital for subsequent treatment, and her outcome is unknown. LESSONS A misdiagnosis or inadequate and/or delayed treatment for a coracoid process osteosarcoma could have grave consequences. Computed tomography and magnetic resonance imaging are essential for a diagnosis, and a biopsy can effectively confirm the diagnosis. Our findings suggest that considering only a single factor, or using incomplete information, can lead to an arbitrary diagnosis.
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Affiliation(s)
- Zhiping Luo
- Department of Orthopaedics, Shenzhen Hospital, Southern Medical University, Shenzhen City
| | - Conglin Ye
- Department of Orthopaedics, the First Affiliated Hospital of Nanchang University, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi, China
| | - Hong-Xun Sang
- Department of Orthopaedics, Shenzhen Hospital, Southern Medical University, Shenzhen City
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Božić D, Josipović M, Bohaček I, Smoljanović T, Bojanić I. OSTEOID OSTEOMA OF THE CORACOID PROCESS: CASE REPORT WITH LITERATURE REVIEW. Acta Clin Croat 2016; 55:505-509. [PMID: 29046018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Osteoid osteoma (OO) is the most common benign osteogenic bone tumor that predominantly affects young adults. OO is commonly localized in long bones, and therefore, it is rarely considered in differential diagnosis of chronic shoulder pain. We report a case of a 22-year-old male athlete, without history of previous trauma, who presented to our Department with chronic shoulder pain, which escalated during the night and responded to nonsteroidal anti-inflammatory drug treatment. Considering these typical symptoms, diagnostic pathway was immediately directed towards OO, with magnetic resonance and computed tomography confirming the diagnosis of OO of the coracoid process (CP). Since neurovascular structures are in the proximity of CP, and this very delicate area does not support radiofrequency ablation, we decided to perform an open procedure with drilling of the lesion and excochleation. The pain withdrew immediately after the procedure, and on six-month follow up the patient remained pain free. In the treatment of OO of the CP, we recommend open surgical procedure with tumor ablation by drilling instead of CP resection, presenting a safe, simple and low-cost method that simultaneously completely destroys the lesion and preserves the anatomical and functional role of CP
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