Presentation
Post shoulder manipulation for dislocation. No pre-manipulation images obtained.
Patient Data
There is an avulsion fracture of the tip of the coracoid process. The avulsed fragment lies lateral to the coracoid, suggesting the pull is from the coracohumeral ligament. No underlying osseous lesion at the coracoid tip appreciated. No other fracture identified. The humeral head is enlocated. High riding humeral with changes at the greater tuberosity in keeping with chronic rotator cuff tendinopathy.
Case Discussion
Avulsion fractures through the tip of the coracoid process are a relatively uncommon scapular fracture. No underlying osseous lesion was however identified on x-ray in this case.
Muscle origins from the coracoid process are the short head of biceps, pectoralis minor and coracobrachialis. Ligamentous attachments include the coracoclavicular, coracoacromial and coracohumeral ligaments.