Beyond the Cuff: MR Imaging of Labroligamentous Injuries in the Athletic Shoulder

Roy, Elizabeth; Cheyne, Ian; Andrews, Gordon; Forster, Bruce B.

doi:10.1148/radiol.2015150364

Cited by 26 publications

(10 citation statements)

References 110 publications

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“…Many anatomic and radiographic measurements of the coracoid process have been reported [17,18,29,30]. Kawasaki et al reported the cross-sectional size at the level of the coracoid base by a study on CT axial measurement of the coracoid base [7].…”

Section: Discussionmentioning

confidence: 99%

A guideline for screw fixation of coracoid process base fracture by 3D simulation

Sun

Wang

et al. 2021

J Orthop Surg Res

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Background Fractures of the base of the coracoid process are relatively rare, but an increasing number of studies have reported using screws to fix coracoid process base fractures. This study was performed to simulate the surgical procedure and obtain the ideal diameter, length, insertion point and angle of the screw from a 3-D axial perspective in Chinese patients. Methods We randomly collected right scapula computed tomography (CT) scans from 100 adults. DICOM-formatted CT scan images were imported into Mimics software. A 3D digital model of the right scapula was established. Two virtual cylinders representing two screws were placed from the top of the coracoid process to the neck of the scapula and across the base of the coracoid process to fix the base of the coracoid process. The largest secure diameters and lengths of the virtual screws were measured. The positions of the insertion points and the directions of the screws were also examined. Results The screw insertion safe zone can exhibit an irregular fusiform shape according to the reconstructed scapula model. The mean maximum diameters of the medial and lateral screws were 7.08 ± 1.19 mm and 7.34 ± 1.11 mm, respectively. The mean maximum lengths of the medial and lateral screws were 43.11 ± 6.31 mm and 48.16 ± 6.94 mm, respectively. A screw insertion corridor with a diameter of at least 4.5 mm was found in all patients. We found sex-dependent differences in the mean maximum diameters and maximum lengths of the two screws. The positions of the two insertion points were statistically different across sexes. Conclusions The study provides a valuable guideline for determining the largest secure corridor for two screws in fixing a fracture at the base of the coracoid process. For ideal screw placement, we suggest individualised preoperative 3D reconstruction simulations. Further biomechanical studies are needed to verify the function of the screws.

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Section: Discussionmentioning

confidence: 99%

A guideline for screw fixation of coracoid process base fracture by 3D simulation

Sun

Wang

et al. 2021

J Orthop Surg Res

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show abstract

“…Many anatomic and radiographic measurements of the coracoid process have been reported [14,15,20,23]. Yoshiteru Kawasaki et al reported the cross-sectional size at the level of the coracoid base by the study on CT axial measurement of the coracoid base [7].…”

Section: Discussionmentioning

confidence: 99%

A guideline for screw fixation of coracoid process base fracture by 3D technology

Sun

Wang

et al. 2020

Preprint

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BackgroundFractures of the base of the coracoid process are relatively rare, but an increasing number of studies have reported using screws to fix basal coracoid process fractures. This study was performed to simulate the surgical procedure and obtain the ideal diameter, length, insertion point and angle of the screw through the method of 3-D axial perspective in Chinese patients.MethodsWe randomly collected the right scapula computed tomography (CT) scans of 100 adults. DICOM-formatted CT-scan images were imported into Mimics software. The 3D digital model of the right scapula was established. Two virtual cylinders representing two screws were placed from the top of the coracoid process to the neck of the scapula and across the base of the coracoid process to fix the basal coracoid process. The largest secure diameters and lengths of the virtual screws were measured. The positions of the insertion points and the directions of the screws were also researched.ResultsThe screw insertion safe zone can exhibit an irregular fusiform shape from the reconstructed scapula model. The mean maximum diameters of the medial and lateral screws were 7.08 ± 1.19 mm and 7.34 ± 1.11 mm, respectively. The mean maximum lengths of the medial and lateral screws were 43.11 ± 6.31 mm and 48.16 ± 6.94 mm, respectively. The screw insertion corridor with a diameter of at least 4.5 mm was found in anyone. We found gender-dependent differences for the mean maximum diameters and the maximum lengths of the two screws. The positions of the two insertion points were statistically significant in different genders.ConclusionsThe study provides a valuable guideline for the largest secure corridor of two screws that fixed the fracture at the base of the coracoid process. For the ideal screw placement, we suggest an individual preoperative 3D reconstruction simulation. Further biomechanical studies are needed to verify the function of the screws.

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“…Pathologies of the posterior labrocapsular and ligamentous complex include reverse Bankart, reverse humeral avulsion of the glenohumeral ligament, extended superior labral anteroposterior tear, posterior labrocapsular periosteal sleeve avulsion, reverse glenolabral articular disruption, and Kim lesions. 7,[10][11][12] Literature indicates that only 2% of patients with shoulder instability present with posterior subluxation. 11 A reverse Bankart lesion is known as separation of the posteroinferior labrum secondary to macrotrauma; however, numerous variants of posterior glenoid labral lesions have also been described in the literature.…”

Section: Discussionmentioning

confidence: 99%

Sonoarthrographic examination of posterior labrocapsular structures of the shoulder joint

Oğul

Taş

et al. 2020

The British Journal of Radiology

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Objective: To describe the posterior labral lesions and labrocapsular abnormalities of the shoulder on sonoarthrography and to compare these findings with MR arthrography results. Methods: 82 shoulders were initially evaluated with ultrasonography and MRI and then were examined with sonoarthrography and MR arthrography following intraarticular injection of diluted gadolinium solution. The ultrasonography images were prospectively evaluated for the presence of posterior labral tear, sublabral cleft, and posterior capsular abnormalities by two radiologists. The diagnostic accuracy of sonoarthrography in the detection of posterior labral tears and posterior labrocapsular variants was compared with that of MR arthrography. Results: In sonoarthrographic examinations of 82 shoulders, 5 and 6 posterior labral tears were identified by Observer 1 and 2, respectively. Moreover, 6 and 7 posterior sublabral clefts, and 2 and 3 posterior synovial folds were identified by Observer 1 and 2, respectively. All the 82 patients were examined with MR arthrography; however, only 14 patients underwent arthroscopic examination. No significant difference was found among the 82 patients with regard to age, gender, and the prevalence of posterior labral tear, posterior labral cleft, and posterior synovial fold (p > 0.05). Interobserver variability showed substantial agreement between the sonoarthrographic and MR arthrographic results of the posterior labrocapsular structures (κ = 0.71, p < 0.05). Conclusion: Posterior labral tears and posterior synovial folds of the shoulder joint can be evaluated non-invasively by sonoarthrography. Advances in knowledge: Variations and pathologies of posterior labrocapsular structures of the glenohumeral joint are relatively uncommon. Direct (MR) arthrography is the gold-standard imaging modality to evaluate of posterior labrocapsular abnormalities of the glenohumeral joint. Sonoarthrography of the glenohumeral joint may be utilized in clinical practice in patients with contraindications to (MRI).

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Beyond the Cuff: MR Imaging of Labroligamentous Injuries in the Athletic Shoulder

Cited by 26 publications

References 110 publications

A guideline for screw fixation of coracoid process base fracture by 3D simulation

A guideline for screw fixation of coracoid process base fracture by 3D simulation

A guideline for screw fixation of coracoid process base fracture by 3D technology

Sonoarthrographic examination of posterior labrocapsular structures of the shoulder joint

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