Coracoid Process Injuries and Treatments
Coracoid process (in Greek, “p Claw-like”) is a small, hook-like projection on the medial edge of the inferior lateral part of the coracoid (hence: coracoid bone). It, along with the acromion, acts to stabilize the upper shoulder joint during humeral movement. It is rarely palpable, however, in the glenohumeral groove between the ilio pause and ilio posterior muscles. The coracoid process is anchored by the large iliotibial artery, which passes through the lower breastbone and into the grooves of the coracoid and ilio posterior muscles.
The Main Funtion of Coracoid Process
The main function of the coracoid process is to provide stable attachment to the glenohumeral and iliotibial bones at the sides of the upper arm. In man, the only bone with this feature in the vicinity of the coracoid muscle is the sartorius. Which inserts onto the upper front of the ulnar fold behind the ilio posterior muscle. Here, the trapezoid ligament anchors the coracoid to the side of the ilio posterior.
The main function of the coracoid process is to mediate friction between two bones while allowing movement between them. Thus, it stabilizes both the ilio posterior and iliotibial joint. It also stabilizes the clavicle, the dominant bone over the humerus, and the clavicular ligament. When this bone and its associated mechanisms are not functioning properly, the entire body will suffer from pain. This is because the structures will be out of alignment.
Treatment of Coracoid Process Injuries
There are several approaches to treat coracoid process injuries. These include the classic surgery, the open approach, and the coracoid punch excision. The former removes the entire coracoid process and the nerves, while the latter includes a minor incision and the creation of a new scaphoid process.
The traditional method of treating a coracoid process injury is through the conventional definition. This involves the removal of a large portion of the shoulder blade along with the underlying muscles and tendons. Later on, the replacement shoulder blade is put in place and a sutured flap is created in its entirety. This procedure is transaxillary osteotomy. A TENS or transcranial magnetic stimulation is then used on the area to promote healing and speed up the process of reattachment of the cortically injured area.
Due to the poor mobility of the affected shoulder blade and the lack of any cross-attachments with the coracoid process and the scapular spine, there is a high risk of the scapulae moving out of place. This is due to poor mechanics of the muscle, poor biomechanics, and poor anatomy. Therefore, in addition to a complete detachment of the rotator cuff, a complete scapular spine shift is possible in some cases. These are a scapulohumeral shift or a transaxillary shift.
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New techniques such as the TENS method make use of electric current to interrupt the mechanical process of the muscular contractions, relax the tensed muscles, reduce the stiffness of the joints and encourage the growth of ligaments, tendons, and ligament attachments. This enables the injured muscle to heal faster and more proficiently.
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Patients with a large coracoid deformity that affects both the upper and lower sections of their arms. They may benefit from the repair of both the upper and lower portions of their coracoid. In the treatment of scapular deformity, the surgeon would use a similar approach to that used for repairing the coracoid.
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