Abstract
IntroductionShoulder dislocations can cause acute and chronic instabilities that need to be addressed in order to restore joint functioning. The transfer of the coracoid process has become a feasible surgical procedure in patients with shoulder instability. Several concomitant injuries after recurrent dislocations have been described.Case presentationA 32-year-old German man presented to our department with a history of recurrent shoulder dislocations. He was diagnosed with an avulsion fracture of the coracoid process and dislocation of an osseous piece with attachment to the conjoined tendons during the surgical transfer of the coracoid process. Therefore, we performed an open Latarjet procedure and reattached the bony piece with the conjoined tendons to the glenoid rim. Three months after the operation the patient presented with a satisfying range of motion and without instabilities or pain. He was able to return to his job.ConclusionsPatients suffering from anterior shoulder dislocation might develop accompanying lesions after numerous dislocations that are not present upon first visit. Different techniques for the reconstruction of the glenoid rim and the restoration of shoulder joint stability have been described in the literature. We opted for a coracoid transfer and achieved an optimal reconstruction, as shown on the postoperative computed tomography scan. An avulsion fracture of the coracoid process with dislocation of the conjoined tendons can not only be found in patients suffering a direct trauma as pointed out in the literature, but also in patients with anterior shoulder instability with recurrent anterior shoulder dislocation.
Highlights
Shoulder dislocations can cause acute and chronic instabilities that need to be addressed in order to restore joint functioning
Different techniques for the reconstruction of the glenoid rim and the restoration of shoulder joint stability have been described in the literature
We opted for a coracoid transfer and achieved an optimal reconstruction, as shown on the postoperative computed tomography scan
Summary
Recurrent anterior shoulder dislocations may cause several complications over time that are not present upon a patient’s first visit. A preoperative CT scan is performed in most cases and might likely give an indication towards this type of injury, if one knows that this accompanying lesion can occur (Figure 1). It might be important to identify the presence of such an injury preoperatively in case of an arthroscopic Latarjet procedure, as it may be impossible to gain the same results afterwards. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. MBalke assisted the operation, performed the follow up examination and helped to draft the manuscript. Author details 1Department of Orthopaedic Surgery, Traumatology and Sports Medicine, Cologne-Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Str. 200, D-51109 Cologne, Germany. Author details 1Department of Orthopaedic Surgery, Traumatology and Sports Medicine, Cologne-Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Str. 200, D-51109 Cologne, Germany. 2Department of Orthopaedic Surgery, Schulthess Clinic, Zurich, Switzerland. 3Sportsclinic Cologne – Practice for Sportstraumatology, Cologne-Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Str. 200, D-51109 Cologne, Germany
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