Skeleton, bones of upper limb
Ian Parkin, Bari Logan, Mark McCarthy in Core Anatomy - Illustrated, 2007
The lateral end of the clavicle forms the acromioclavicular joint (27) with the acromion (28) of the scapula. The joint is stabilized by the strong coracoclavicular ligament, which has two segments (conoid and trapezoid) and firmly binds the clavicle to the underlying coracoid process (29). Both sternoclavicular and acromioclavicular joints are synovial but atypical – they have fibrocartilage on the articular surfaces and also have intracapsular discs. If the clavicle is fractured following direct trauma or a fall on the extended limb it tends to fracture between the lateral third and medial two-thirds. The weight of the upper limb pulls the lateral segment of the clavicle inferiorly.
Effect of applying consistent pressure to the stationary and the moving arm on measurement reliability of glenohumeral internal rotation range of motion
Published in Physiotherapy Theory and Practice, 2019
Ui-jae Hwang, Oh-yun Kwon, In-cheol Jeon, Sung-hoon Jung, Moon-hwan Kim
Objectives: The aim of this study was to determine the inter-rater reliability of glenohumeral internal rotation (GIR) range of motion (ROM) and pressure measurements among four measurement methods: (1) Manual stabilization of the humeral head and coracoid process (MSHC) without applying consistent pressure (ACP) to both the stationary and the moving arms (BSaMA); (2) MSHC with ACP to the moving arm; (3) MSHC with ACP to the stationary arm; and (4) MSHC with ACP to BSaMA. Design: Test-retest analyses. Participants: 39 subjects with GIR deficit. Main outcome measures: GIR ROM and pressure were measured on the stationary or moving arm by four examiners using the Clinometer application and a pressure biofeedback unit. Results: GIR ROM measurement with MSHC and ACP to the moving arm resulted in the lowest intra-class correlation coefficient (ICC = .43); the ICC for MSHC without ACP to BSaMA was .54; that for MSHC with ACP to the stationary arm was .77; and that for MSHC with ACP to BSaMA was highest, at .81. Conclusion: MSHC with ACP to both arms leads to reliable GIR ROM measurement in a clinical setting.
Deformation of coracoacromial ligament during overhead movement as an early indicator of subacromial impingement in elite adolescent badminton players
Published in The Physician and Sportsmedicine, 2019
Szu-Heng Wang, Tung-Yang Yu, Yin-Chou Lin, Pei-Chi Liao, Wen-Chung Tsai
Objectives: Deformation of the coracoacromial ligament during overhead movement has been linked to shoulder pathologies such as impingement and rotator cuff tear. We, therefore, explored this relationship in a group of elite adolescent badminton players. Method: We performed bilateral shoulder physical and ultrasonographic examination in 35 adolescent asymptomatic badminton players, 13 players with unilateral shoulder pain, and 15 non-athletes of similar age. Coracoacromial ligament deformation, defined as the maximal vertical distance between the ligament apex to a line connecting the acromion and coracoid process, was measured during shoulder abduction and internal rotation and compared within and between groups. Other ultrasonographic measurements and the incidence of shoulder pathologies were also evaluated. Result: Among badminton athletes who reported dominant shoulder pain, coracoacromial ligament deformation was significantly larger in their dominant shoulder than in their non-dominant shoulder (3.5 and 2.0 mm, respectively; p = 0.013); this difference was not present in other groups. Regardless of the presence or absence of pain, athletes displayed more coracoacromial ligament deformation and increased supraspinatus tendon thickness in their dominant shoulder than did the control group. Abnormal ultrasound findings were noted in all groups; however, the incidence was not significantly different. Conclusion: Increased coracoacromial ligament deformation during overhead movement is associated with shoulder pain in elite adolescent badminton players. Our findings may help clinicians identify athletes at risk of subacromial impingement syndrome.
Coracoclavicular Involvement - an Atypical Manifestation in Rheumatoid Arthritis: SHORT REPORT
Published in Scandinavian Journal of Rheumatology, 1999
Janne Lehtinen, Kalevi Kaarela, Eero Belt, Markku Kauppi, Matti U.K. Lehto
An inception cohort of 74 patients with seropositive and erosive RA were followed up for 15 years. All 148 shoulders were radiographed with a standard method at the 15-year follow-up. The coracoclavicular region was evaluated from each radiograph. In addition, the distance between the processus coracoideus and the superior margin of the clavicle was measured. Only one clavicle had elongated, shallow erosion on the undersurface at the insertion area of the coracoclavicular ligaments. In this case the distance between the coracoid process and clavicle was 25 mm, whereas the mean distance of all shoulders (n=148) was 17.4 mm (range 9-25 mm). We conclude that resorption on the undersurface of the distal clavicle is an atypical manifestation in rheumatoid arthritis. The origin of this atypical lesion is a not diminished distance between the processus coracoideus and the clavicle. Inflammation of the coracoclavicular ligaments is most likely the reason for this lesion.