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Orthop Traumatol Surg Res. 2014 Apr;100(2):e167-70. doi: 10.1016/j.otsr.2013.09.018. Epub 2014 Mar 5.

Coracoacromial ligament section under ultrasonographic control: a cadaveric study on 20 cases.

Author information

1
Département d'orthopédie-traumatologie, CHU de Caen, avenue Côte-de-Nacre, 14000 Caen, France. Electronic address: delforge-s@chu-caen.fr.
2
Service de rhumatologie, CHU de Caen, avenue Côte-de-nacre, 14000 Caen, France.
3
Département d'orthopédie-traumatologie, CHU de Caen, avenue Côte-de-Nacre, 14000 Caen, France.

Abstract

INTRODUCTION:

The coracoacromial ligament is a complex anatomical structure involved in the development of subacromial impingement; treatment is founded on sectioning the ligament, with or without associated arthroscopic acromioplasty and debridement.

HYPOTHESIS:

Complete coracoacromial ligament section can be performed under ultrasound, without lesion to surrounding structures.

MATERIALS AND METHODS:

The coracoacromial ligament was sectioned on the coracoid side, under ultrasound navigation, in 10 cadavers donated to science: i.e. 20 shoulders. After ultrasound location of the shoulder structures, sectioning was performed with a skin incision at the level of the deltopectoral sulcus. Secondary surgical control checked conservation of the acromial branch of the thoracoacromial artery, and the quality of the procedure.

RESULTS:

Mean surgery duration was 18.5 minutes (±5 min). Seventeen sections were complete (85%). Artery location was hampered by the impossibility of using Doppler on these cadavers, yet even so there were only 2 vascular lesions. There were no accidental rotator cuff or cartilaginous lesions.

CONCLUSION:

This relatively non-invasive technique is quick and less heavy than open surgery, opening up new treatment perspectives. It could be indicated in coracoid and subacromial impingement before opting for surgery, or as a complement to surgery. It does, however, involve a learning curve and requires solid ultrasound skills.

KEYWORDS:

Coracoacromial ligament; Coracoid impingement; Impingement syndrome; Subacromial impingement; Ultrasound

PMID:
24613440
DOI:
10.1016/j.otsr.2013.09.018
[Indexed for MEDLINE]
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