Not Alone

​"Hey, what do you think of this? It isn't dislocated, but this guy was in a fight, and has a lot of shoulder pain," a colleague said to me.It seems that the humerus gets virtually all the attention in shoulder x-rays, particularly in the Y view. Many are done with the image after determining the head truly sits in the middle of the Y between the coracoid and the acromion. There is more to shoulder films than just the humeral head's location, however. Take another look at the coracoid and the acromion.Scapular fractures account for just one percent of fractures. The vast majority of these are of the body and the neck. Coracoid fractures make up just more than 10 percent of all scapular fractures. Although rare, these are not to be missed because they almost never occur alone. One should also look for AC separations, glenoid injuries, rotator cuff tears, and fractures of the acromion or lateral clavicle. AC separations are most commonly associated with coracoid fracture.Orthopedists may also refer to the coracoid as the lighthouse of the shoulder. It actually looks sort of like a lighthouse. This structure marks where the neurovascular bundles travel nearby. Of note, it anchors multiple tendons and ligaments. Fractures of this tiny structure may shine a light on many more problems the patient could have.The CT confirmed those initial concerning lucent lines at the coracoid base and the acromion. Both were broken. As is the general rule, the coracoid often does not ...
Source: Lions and Tigers and Bears - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs