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The coracoclavicular ligament connects the clavicle to the coracoid process of the scapula. [1] It is not part of the acromioclavicular joint articulation, but is usually described with it, since it keeps the clavicle in contact with the acromion. It consists of two fasciculi, the trapezoid ligament in front, and the conoid ligament behind. [2]
The coracoid process acts as an attachment and origin for a large number of muscles (attached muscles not labeled here). The coracoid process is a thick curved process attached by a broad base to the upper part of the neck of the scapula; [2] it runs at first upward and medially; then, becoming smaller, it changes its direction, and projects forward and laterally.
The Apley scratch test specifically tests range of motion and in a normal exam, an individual should be able to reach C7 on external rotation, and T7 on internal rotation. Evaluation of distal pulses; Strength testing: wrist extension tests the radial nerve, finger abduction tests the ulnar nerve, and thumb apposition tests the median nerve.
There is a 2- to 3-fold increase in the coracoclavicular distance, causing such a severe displacement that the clavicle almost pierces the skin. [11] The humerus and scapula drop without having the clavicular strut to lift them, which manifests as a severely drooping shoulder. [ 11 ]
Grade I is slight displacement of the joint, and a badly stretched or partially torn AC ligament. It has the normal separation of <4 mm. Grade II is a partial dislocation of the AC joint with a complete disruption tear of the AC joint and a partial disruption of coracoclavicular ligament. The AC gap is >5 mm. Grades I and II never require ...
It may be damaged during a shoulder injury. [4] The attachment of the coracoacromial ligament may be moved from acromion to the end of the clavicle when reconstructing the acromioclavicular joint. [5] [6] This often fails. [5] It has lower strength than the coracoclavicular ligament. [6]
The most important ligament involved in shoulder joint stability is the Inferior Glenohumeral Ligament. During abduction of the arm, the middle and inferior ligaments become taut while the superior ligament relaxes. The radius of curvature of the head of the humerus is greater superiorly than inferiorly, which further stretches these ligaments ...
Modern variations of the procedure may use additional fixation methods to better stabilize the distal clavicle end as the original construction is rather weak compared to the unharmed shoulder. Even with these modifications, the modern surgeries do not match intact coracoclavicular ligament strength in cadaveric testing. [ 3 ]