Bhatia Deepak N, de Beer Joe F, du Toit Donald F
Cape Shoulder Institute, Cape Town, South Africa.
Clin Anat. 2007 Oct;20(7):774-84. doi: 10.1002/ca.20525.
The coracoid process forms an important part of scapular-glenoid construct and is involved in many surgical procedures on the glenohumeral joint. The unique three-dimensional orientation of each coracoid pillar makes radiographic imaging difficult. Congenital variations and minimal traumatic/iatrogenic changes in this orientation can predispose to subcoracoid impingement. We performed a quantitative and statistical analysis of the osseous anatomy of the coracoid process in 101 scapulae; the purpose was to determine the anatomical variations and gender-specific differences in the length, breadth, thickness, vertical and horizontal projections, and triplane angulations of each individual coracoid pillar. All parameters were measured in reference to the glenoid plane to ensure surgical and radiological applicability. The mean dimensions of the inferior coracoid pillar were 31.1 x 16.6 x 9.9 mm and that of the superior coracoid pillar were 41.7 x 14.2 x 8.4 mm (medial)/6.6 mm (lateral). The mean maximal harvestable coracoid length measured 19.0 mm. The mean angular orientation of the inferior coracoid pillar, with reference to the glenoid, measured 51.2 degrees (axial), 126.1 degrees (sagittal), and 134.6 degrees (coronal), and that of the superior coracoid pillar measured 146.1 degrees (axial) with an interpillar angulation of 84.9 degrees (axial). A statistically significant gender difference (P < 0.05) was found in the lengths, breadths, and projections of each coracoid pillar. We used data from this study to devise two new radiographic views (for imaging individual coracoid pillars), to calculate dimensions and orientation of internal fixation/prosthetic hardware during surgery, and conceptualize a geometric model to explain the role of measured parameters in coracoid impingement syndrome.
喙突是肩胛盂结构的重要组成部分，参与了许多盂肱关节的外科手术。每个喙突支柱独特的三维方向使得放射成像困难。这种方向的先天性变异以及微小的创伤性/医源性改变可能导致喙突下撞击。我们对101块肩胛骨的喙突骨性解剖结构进行了定量和统计分析；目的是确定每个喙突支柱在长度、宽度、厚度、垂直和水平投影以及三平面角度方面的解剖变异和性别差异。所有参数均参照肩胛盂平面进行测量，以确保手术和放射学适用性。喙突下支柱的平均尺寸为31.1×16.6×9.9毫米，喙突上支柱的平均尺寸为41.7×14.2×8.4毫米（内侧）/6.6毫米（外侧）。测量的平均最大可收获喙突长度为19.0毫米。喙突下支柱相对于肩胛盂的平均角度方向测量为51.2度（轴向）、126.1度（矢状）和134.6度（冠状），喙突上支柱的平均角度方向测量为146.1度（轴向），支柱间角度为84.9度（轴向）。在每个喙突支柱的长度、宽度和投影方面发现了具有统计学意义的性别差异（P<0.05）。我们利用本研究的数据设计了两种新的放射学视图（用于成像单个喙突支柱），以计算手术期间内固定/假体硬件的尺寸和方向，并构思了一个几何模型来解释测量参数在喙突撞击综合征中的作用。
