Pectoralis minor tendon in the rotator interval: arthroscopic, magnetic resonance imaging findings, and clinical significance

Lim, Tae Kang; Koh, Kyoung Hwan; Yoon, Young Cheol; Park, Jae Hyun; Yoo, Jae Chul

doi:10.1016/j.jse.2015.03.003

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…Variations in the attachment of pectoralis minor were reported in previous literatures [16][17][18]. Orientation with these ectopic attachments is important clinically, as it has its implications especially for plastic surgeons because the muscle is frequently used for free flaps.…”

Section: Discussionmentioning

confidence: 93%

“…Moreover, precise knowledge of its attachment is crucial for orthopedic surgeons to manage restricted movements of shoulder joint. Lim et al reported tendinous extension of the pectoralis minor tendon reaching supraspinatus tendon as 11% prevalence, and it was preoperatively detected on MRI [16]. Tubbs and Salter reported an unusual bony attachment of pectoralis minor in an adult cadaver where the left pectoralis minor had no attachment to the coracoid process of scapula, but attached directly to fibrous capsule of the glenohumeral joint [18].…”

Section: Discussionmentioning

confidence: 99%

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Anatomic Study of the Coracoid Process: Safety Margin for Osteotomy for Shoulder Surgery

Khanfour¹,

Nabil²,

Motawea³

2018

IJAR

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Background: Surgical procedures as coracoid osteotomy, transfer, and fixation are used for management of recurrent anterior shoulder instability. However, the peculiar anatomy of bony and soft tissue footprints of the coracoid, as they relate to these surgical procedures, need further detailed studies owing to its clinical importance.Aim of the work: to obtain safety margin for osteotomy of the coracoid process. Materials and methods:The material of this work included twenty upper limbs of formalin preserved specimens obtained from the dissecting room of anatomy department, faculty of medicine, Alexandria University. Dimensions of the coracoid process were recorded. Anatomical measurements between the tip of the coracoid process to the anterior and posterior margins of the tendon of pectoralis minor were recorded. Distances between the tip of the coracoid process and the anterior and posterior margins of coracoacromial ligament, coracohumeral ligament, and the most distal point of conoid and trapezoid ligaments were recorded.Results: The mean length, width, and height of the coracoid were 4.25, 1.4, 1.16 cm respectively. The mean distance between the tip of the coracoid process to the anterior and posterior margins of pectoralis minor were 1.07 and 2.04 cm respectively. The mean distance between tip of coracoid process and coracoacromial ligament (anterior and posterior margins), coracohumeral, conoid and trapezoid ligaments were 1.32, 2.19, 1.11, 3.70 and 2.73 cm respectively. Conclusion:A safety margin of 2.35 cm from the tip of the coracoid process is recommended to avoid injury of coracoclavicular ligament. This distance was correlated with the distance between the tip and the posterior margin of pectoralis minor muscle.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Anatomic Study of the Coracoid Process: Safety Margin for Osteotomy for Shoulder Surgery

Khanfour¹,

Nabil²,

Motawea³

2018

IJAR

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“…Scarce information on the prevalence of anomalous insertions of the PMM may be found in literature (Table 2). The results were based on anatomical dissection [8] or imaging modalities as ultrasound [17], MR arthrography [3] and standard MRI [4, 18]. Ectopic tendons were found in 1.5–34% of the evaluated cases [3, 4, 8, 17, 18].…”

Section: Discussionmentioning

confidence: 99%

“…The results were based on anatomical dissection [8] or imaging modalities as ultrasound [17], MR arthrography [3] and standard MRI [4, 18]. Ectopic tendons were found in 1.5–34% of the evaluated cases [3, 4, 8, 17, 18]. Information on their specific LeDouble classification [6] were only available in three of those papers, reporting LeDouble type I in 7.7–33.3% [4, 8], LeDouble type II in 5.7–66.6% [4, 8] and LeDouble Type III in 1.5% [3].…”

Section: Discussionmentioning

confidence: 99%

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Ectopic tendons of the pectoralis minor muscle as cause for shoulder pain and motion inhibition—Explaining clinically important variabilities through phylogenesis

Schwarz

Hirtler

2019

PLoS ONE

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OJECTIVE Clinical consequences of ectopic tendons of the pectoralis minor muscle (PMM) for shoulder pain and range-of-motion limitation have been demonstrated. For better understanding the existence of such ectopic tendons, a phylogenetic hypothesis is proposed. METHODS Forty-five shoulders of anatomical specimens were dissected and examined. Insertions areas of PMM were measured and occurring aberrant tendons were identified. Their relationship with the coracohumeral ligament (CHL) described and samples of the ligament were collected and histologically stained. RESULTS The prevalence of PMM variations was 37.84%. Shoulders with variations showed a statistically significant smaller coracopectoral distance (p<0.001) and larger insertion areas (p<0.003) than shoulders without. A strong negative correlation between these two variables (p<0.001, r = -0.620) was shown. CONCLUSIONS The presented results prompted the conclusion that the CHL may be in fact the remnant of the pectoralis minor tendon (PMT), which migrated from the humerus to the coracoid process through the process of phylogenetic evolution. Variations of PMTs are significantly more common than in previous studies. Imaging techniques appear to be insufficiently sensitive for reliably detecting ectopic tendons. Especially in patients experiencing shoulder pain and stiffness in whom the commoner pathologies have been ruled out the possibility of ectopic PMT should be kept in mind and ruled out.

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Classification of unusual insertion of the pectoralis minor muscle

et al. 2018

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Pectoralis minor tendon in the rotator interval: arthroscopic, magnetic resonance imaging findings, and clinical significance

Cited by 7 publications

References 15 publications

Anatomic Study of the Coracoid Process: Safety Margin for Osteotomy for Shoulder Surgery

Anatomic Study of the Coracoid Process: Safety Margin for Osteotomy for Shoulder Surgery

Ectopic tendons of the pectoralis minor muscle as cause for shoulder pain and motion inhibition—Explaining clinically important variabilities through phylogenesis

Classification of unusual insertion of the pectoralis minor muscle

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