Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA
This video speaks about the coracoid, conoid, coronoid processes. Coracoid is the hook shaped bony process of scapula. It is considered as the surgeons lighthouse. It is safe to do surgical approaches lateral to coracoid process. The neuro vascular bundle lies medial to coracoid process. Three ligaments attached to coracoid process are coracoacromial, coracoclavicular and coracohumeral ligaments.
Coracoid process gives attachment to conjoint tendon. Two different types of coracoid fractures are described.
Type 1 :fracture proximal to coracoclavicular ligament, usually associated with other injuries.
Type 2:fracture distal to coracoclavicular ligament.
Subcoracoid impingement is an impingement of the subscapularis tendon between the coracoid and lesser tuberosity of the proximal humerus. Coracoid process is also important in anchoring, tendons to the clavicle in order to restore the stability of AC joint.
The latarjet bristow procedure is performed when there is bone loss in the front of glenoid cavity with multiple dislocations of the shoulder and the coracoid is transferred to that area after osteotomy.
Conoid is a part of coracoclavicular ligament . AC joint is stabilised by joint capsule, by the AC ligament which prevents anterior and posterior translation and also by the coracoclavicular ligament which prevents vertical displacement of clavicle. Injury to coracoclavicular ligament will cause vertical displacement of clavicle and causes type 3 AC joint separation and higher grades.
If the fracture of distal third of clavicle is lateral to the ligament, then the fracture is usually stable and surgery is not needed but if the fracture is medial to the ligament, it is considered unstable.This type of fracture has high incidence of nonunion and could be an indication for surgery.
Coronoid process is a triangular process which projects from the anterior proximal ulna. There are three types of coronoid process fracture according the Regan and Morrey Classification
Excellent source of learning