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Surgery about the coracoid: neurovascular structures at risk
Ian K Y Lo1, Stephen S Burkhart, Peter M Parten
1The San Antonio Orthopaedic Group, Texas, USA.
Summary
This study mapped neurovascular structures near the coracoid, finding surgery about this bone is generally safe. The lateral cord of the brachial plexus and axillary nerve are at greatest risk during specific coracoid dissections.
Area of Science:
- Orthopedic Surgery
- Anatomy
- Surgical Risk Assessment
Background:
- Coracoid procedures are common in shoulder surgery.
- Understanding risks to surrounding neurovascular structures is crucial for patient safety.
Purpose of the Study:
- To investigate the proximity of critical neurovascular structures to the coracoid bone.
- To quantify the risk of injury during coracoid-related surgical procedures.
Main Methods:
- Anatomic dissection of five fresh-frozen cadaveric shoulders.
- Precise measurement of distances from coracoid tip and base to axillary nerve, musculocutaneous nerve, lateral cord of brachial plexus, and axillary artery.
Main Results:
- The anteromedial aspect of the coracoid tip and base are closest to neurovascular structures.
- Specific minimum distances were recorded: e.g., 28.5 mm (coracoid tip to lateral cord) and 29.3 mm (coracoid base to axillary nerve).
- Coracoid dimensions (width, length, thickness) were also determined.
Conclusions:
- Surgery involving the coracoid is relatively safe.
- The lateral cord of the brachial plexus and axillary nerve are the most vulnerable structures during specific coracoid dissections.
- Arthroscopic techniques focusing on the lateral coracoid further enhance safety by increasing distance from neurovascular elements.