• Title/Summary/Keyword: Subcoracoid impingement

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Subcoracoid impingement After the Fixation of the Fractured Coracoid Process -A Case Report- (견관절 오구돌기 골절의 고정 후 발생한 오구돌기하 충돌증후군 - 증례 보고 -)

  • Ku, Jung-Hoei;Cho, Hyung-Lae;Cho, Su-Hyun;Hwang, Tae-Hyok;Park, Man-Jun;Choi, Jae-Hyuk
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.3
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    • pp.192-195
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    • 2010
  • Subcoracoid impingement resulting from abnormal contact between the anterosuperior humerus and the anterior coracoacromial arch represents an uncommon source of anterior shoulder pain. Certain operative procedures can also alter the relationship between the coracoid and the lesser tuberosity, leading to impingement of the interventing soft tissue, including the subscapularis and the bursa. We describe an unique case of subcoracoid impingement with the tear of subscapularis tendon after the internal fixation of the fractured coracoid process with cannulated screw due to crowding of the coracohumeral space. Arthroscopic removal of the screw and repair of the subscapularis in our patient resulted in successful resolution of his symptoms. Although subcoracoid impingement is a rare cause of shoulder pain, failure to diagnose and treat this condition may represent a significant cause of failed shoulder surgery.

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Ultrasound Measurement of Coracohumeral Distance in Patients with or without Subcoracoid Impingement (오구돌기하 충돌 증후군 유무에 따른 초음파를 이용한 상완오구돌기 계측)

  • Jang, Suk Hwan;Kim, Sang Bum
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.20-27
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    • 2014
  • Purpose: The purpose of this study was to evaluate coracohumeral distance (CHD) in patients with or without subcoracoid impingement with hypothesis that patients with subcoracoid impingement would have narrower CHD. Materials and Methods: One hundred twenty-four patients with subacromial impingement were evaluated. The subjects with subcoracoid impingement which was affirmed clinically and confirmed by ultrasound guided subcoracoid injection (n=28) was compared with patients with subacromial impingement only (n=96). Patients with stiffness and rotator cuff tear were excluded. Absolute CHD was measured on magnetic resonance imaging (MRI) axial images and on ultrasound with the humerus in neutral position and internal rotation. Also relative ratio of distance difference (RRDD) defined as the difference of CHD in neutral position and internal rotation compared with absolute CHD in neutral on ultrasound was also measured. Results: The distance measured in neutral position was similar between US imaging and MRI (p>0.05) and both measurements did not have significant difference between the two groups (p>0.05). On ultrasound, the difference in CHD in internal rotation between the two groups nearly met the level of significance (p=0.07). No significant difference of CHD difference in two humeral positions was seen between the two groups. However, RRDD value was significantly greater in subcoracoid impingement group (p<0.05). Conclusion: No significant difference of CHD was seen between the subcoracoid impingement group and the control group. RRDD value was greater in subcoracoid impingement group suggesting that individualized coracohumeral distance in internal rotation should be taken into account when assessing patients with subcoracoid impingement.

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Treatment of Painful Rotator Interval Widening After Subcoracoid Decompression in Elite Archer - Case Report - (양궁 선수의 오구 충돌 증후군의 치료 후 발생한 회전근 간격의 손상에 대한 치료 - 증례 보고 -)

  • Park, Jin-Young;Lee, Seung-Jun
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.280-285
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    • 2010
  • Purpose: Coracoid impingement syndrome refers to subscapularis impingement between the coracoid process and lesser tuberosity of the humerus, and pain may occur when the arm is positioned in forward flexion, internal rotation and adduction. This position is common for archers. Material and methods: A female archer with coracoid impingement syndrome that was uncontrolled by conservative therapy underwent arthroscopic subcoracoid decompression. At the 20th postoperative month of follow up, she complained of painful rotator interval widening and so she underwent arthroscopic rotator interval plication. Results: At the postoperative 6th month of follow up after the second operation, she showed no pain and good functional results, and she returned to competing as an archer. Conclusion: We have reported here on a case of successful treatment of painful rotator widening after subcoracoid decompression in an elite archer.