Coracoacromial ligament section under ultrasonographic control: a cadaveric study on 20 cases.

Abstract:

INTRODUCTION:The coracoacromial ligament is a complex anatomical structure involved in the development of subacromial impingement; treatment is founded on sectioning the ligament, with or without associated arthroscopic acromioplasty and debridement. HYPOTHESIS:Complete coracoacromial ligament section can be performed under ultrasound, without lesion to surrounding structures. MATERIALS AND METHODS:The coracoacromial ligament was sectioned on the coracoid side, under ultrasound navigation, in 10 cadavers donated to science: i.e. 20 shoulders. After ultrasound location of the shoulder structures, sectioning was performed with a skin incision at the level of the deltopectoral sulcus. Secondary surgical control checked conservation of the acromial branch of the thoracoacromial artery, and the quality of the procedure. RESULTS:Mean surgery duration was 18.5 minutes (±5 min). Seventeen sections were complete (85%). Artery location was hampered by the impossibility of using Doppler on these cadavers, yet even so there were only 2 vascular lesions. There were no accidental rotator cuff or cartilaginous lesions. CONCLUSION:This relatively non-invasive technique is quick and less heavy than open surgery, opening up new treatment perspectives. It could be indicated in coracoid and subacromial impingement before opting for surgery, or as a complement to surgery. It does, however, involve a learning curve and requires solid ultrasound skills.

authors

Delforge S,Lecoq B,Hulet C,Marcelli C

doi

10.1016/j.otsr.2013.09.018

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

e167-70

issue

2

issn

1877-0568

pii

S1877-0568(14)00034-6

journal_volume

100

pub_type

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