Avulsion fracture coraco-clavicular ligament origin

Case contributed by Dr Chris O'Donnell

Presentation

Fall off a quad bike. Now severe pain in region of AC joint

Patient Data

Age: 14 years
Gender: Male

Bone fragment arising from the base of the coracoid process (arrow).  Gleno-humeral joint is normal

CT

CT performed to better delineate the fracture site

Avusion of bone from the base of the coracoid on its cephalad surface at the origin of the coraco-clavicular ligament.  Associated soft tissue swelling indicating acute injury.  This is at the site of an ossification centre of the coracoid akin to the more common avusion injury in the pelvis at the rectus femoris tendon origin.  Note slight upward displacement of the clavicle in relation to the acromion indicating that this is primarily an AC joint injury with disruption to the ligament attachment due to traumatic upward displacement of the clavicle.  In children ligaments are often stronger than bone attachments thus fracture avulsions as seen here are relativey common.

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Case information

rID: 29459
Case created: 26th May 2014
Last edited: 20th Nov 2015
Inclusion in quiz mode: Included

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