The online version of this article (doi:10.1186/1752-1947-8-394) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
MMS assisted the operation, put together all figures and wrote the manuscript. MBalke assisted the operation, performed the follow up examination and helped to draft the manuscript. PK took the intraoperative pictures and corrected the manuscript. BB corrected the manuscript. MBanerjee acquired the patient, examined the patient preoperatively and performed the operation. All authors read and approved the final manuscript for publication.
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.
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.
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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Neyton L, Young A, Dawidziak B, Visona E, Hager JP, Fournier Y, Walch G: Surgical treatment of anterior instability in rugby union players: clinical and radiographic results of the Latarjet-Patte procedure with minimum 5-year follow-up. J Shoulder Elb Surg. 2012, 21: 1721-1727. 10.1016/j.jse.2012.01.023. CrossRef
Giles JW, Boons HW, Elkinson I, Faber KJ, Ferreira LM, Johnson JA, Athwal GS: Does the dynamic sling effect of the Latarjet procedure improve shoulder stability? A biomechanical evaluation. J Shoulder Elb Surg. 2013, 22: 821-827. 10.1016/j.jse.2012.08.002. CrossRef
Sugaya H, Moriishi J, Dohi M, Kon Y, Tsuchiya A: Glenoid rim morphology in recurrent anterior glenohumeral instability. J Bone Joint Surg Am. 2003, 85-A: 878-884. PubMed
Bigliani LU, Newton PM, Steinmann SP, Connor PM, McLlveen SJ: Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder. Am J Sports Med. 1998, 26: 41-45. PubMed
Eyres KS, Brooks A, Stanley D: Fractures of the coracoid process. J Bone Joint Surg (Br). 1995, 77: 425-428.
Goss TP: The scapula: coracoid, acromial, and avulsion fractures. Am J Orthop (Belle Mead NJ). 1996, 25: 106-115.
Schmid SL, Farshad M, Catanzaro S, Gerber C: The Latarjet procedure for the treatment of recurrence of anterior instability of the shoulder after operative repair: a retrospective case series of forty-nine consecutive patients. J Bone Joint Surg Am. 2012, 94: e75-10.2106/JBJS.K.01270. CrossRefPubMed
- Avulsion fracture of the coracoid process in a patient with chronic anterior shoulder instability treated with the Latarjet procedure: a case report
Marco Michael Schneider
- BioMed Central