Role of Coracoacromial Ligament and Related Structures in Glenohumeral Stability: A Cadaveric Study

2012 ◽  
Vol 21 (04) ◽  
pp. 210-217 ◽  
Author(s):  
Claude T. Moorman ◽  
Russell F. Warren ◽  
Xiang-Hua Deng ◽  
Thomas L. Wickiewicz ◽  
Peter A. Torzilli
Keyword(s):  
Cadaveric Study ◽  
Coracoacromial Ligament

scholarly journals Odontoid process fractures: the role of the ligaments in maintaining stability. A biomechanical, cadaveric study

SICOT-J ◽  
2015 ◽  
Vol 1 ◽  
pp. 11 ◽  
Author(s):  
Oliver Richard Boughton ◽  
Jason Bernard ◽  
Matthew Szarko
Keyword(s):  
Odontoid Process ◽  
Cadaveric Study

scholarly journals The Role of Deep Deltoid Ligament in Ankle Fracture Stability: A Biomechanical Cadaveric Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0035
Author(s):  
Daniel McCormack ◽  
Sayyied J. Kirmani ◽  
Sheweidin Aziz ◽  
Radwane Faroug ◽  
Jitendra Mangwani
Keyword(s):  
Ankle Fracture ◽  
Dynamic Stress ◽  
Cadaveric Study ◽  
Ankle Fractures ◽  
Deltoid Ligament ◽  
Lateral Side ◽  
Posterior Portion ◽  
Stage 4 ◽  
Talar Tilt

Category: Ankle; Basic Sciences/Biologics; Trauma Introduction/Purpose: Supination-external rotation (SER) injuries make up 80% of all ankle fractures. SER stage 2 injuries (AITFL and Weber B) are considered stable. SER stage 3 injury includes disruption of the posterior malleolus (or PITFL). In SER stage 4 there is either medial malleolus fracture or deltoid injury. SER 4 injuries have been considered unstable, requiring surgery. The deltoid ligament is a key component of ankle stability, but clinical tests to assess deltoid injury have low specificity. This biomechanical cadaveric study specifically investigates the role of the components of the deep deltoid ligament in the stabillity of SER ankle fractures. Methods: In the first phase of the study, three specimens were utilised to standardise dissection of the deltoid ligament and creation and fixation of SER ankle fracture. In phase two, four matched pairs (8 specimens) were tested using this standardised protocol (Figure1). Specimens were sequentially tested for stability when axially loaded with a custom rig with up to 750N. Specimens were tested with: ankle intact; lateral injury (AITFL and Weber B); additional posterior injury (PITFL); additional anterior deep deltoid; additional posterior deep deltoid; lateral side ORIF. Clinical photographs and radiographs were recorded at each stage. In addition, dynamic stress radiographs were performed after sectioning the deep deltoid and following fracture fixation to assess talar tilt in eversion. Results: All specimens behaved in an identical manner when subjected to this standardised protocol. When the posterior deep deltoid ligament was intact, the ankle remained stable when loaded and showed no talar tilt on dynamic stress test. Once the posterior deep deltoid ligament was sectioned, there was demonstrable instability in all specimens. Surgical stabilisation of the lateral side using standard technique with a plate prevented talar shift but not talar tilt. In adequately stabilised ankle specimens, there was no loss of fixation on axial loading. Conclusion: This biomechanical cadaveric experiment demonstrates that under the standardised test conditions, all SER fracture ankle specimens with an intact posterior deep deltoid ligament behaved as stable injuries. The posterior portion of the deep deltoid ligament is a crucial structure in conferring stability to SER stage 4 injuries. The clinical implication of this is that when the posterior deep deltoid ligament is intact, SER fractures may be managed without surgical intervention in a plantigrade cast. We also conclude that without immobilisation, the talus may tilt in the mortise risking long-term deltoid incompetence.

Anatomy of the Sciatic Nerve in Relation to the Bernese Periacetabular Osteotomy: A Cadaveric Study

2021 ◽  
Author(s):  
Ajay C. Kanakamedala ◽  
Siddharth A. Mahure ◽  
David A. Bloom ◽  
Edward Mojica ◽  
David J. Kirby ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Periacetabular Osteotomy ◽  
Cadaveric Study ◽  
Posterior Column ◽  
Posterolateral Approach ◽  
Surgical Safety ◽  
Standard Deviation Range ◽  
Hip Flexion ◽  
Hip Extension

AbstractPrior studies have examined the role of hip and knee positioning, specifically hip extension and knee flexion, to reduce the risk of sciatic nerve palsy during the Bernese periacetabular osteotomy. They have qualitatively noted that the sciatic nerve moves farther from the connection between the ischial and posterior column osteotomies in hip extension than flexion but has not precisely measured this change in position. This cadaveric study aimed to quantitatively evaluate how hip positioning affects the location of the sciatic nerve relative to the connection between the ischial and posterior column osteotomies. We dissected four cadaveric specimens (three females and one male) with a mean age of 83.0 ± 7.8. An anterior Smith–Peterson approach was performed to allow the cuts for the periacetabular osteotomy (PAO). A posterolateral approach was taken to identify the sciatic nerve and its emergence from the pelvis. Measurements were performed on the width of the posterior column and, in both hip flexion and extension, the distance from the emergence of the sciatic nerve from the pelvis to the connection point between the ischial and posterior column osteotomies. Each measurement was performed independently by two observers. All data are reported as a mean ± standard deviation (range). The width of the posterior column was 4.84 ± 0.48 cm (range: 4.20–5.35 cm). The distances from the sciatic nerve's emergence to the osteotomy connection point in extension and flexion were 4.73 ± 0.79 and 2.93 ± 0.85 cm, respectively. The distance from the sciatic nerve's emergence to the osteotomy connection point was significantly greater in hip extension than hip flexion (p = 0.021). When the hip is flexed, the distance from the sciatic nerve to the posterior column osteotomy connection point is significantly less than when it is in extension. This anatomic finding is essential for surgical safety, as it provides further evidence on the importance of positioning for reducing the risk of sciatic nerve injury during a PAO.

The Association between Coracoacromial Ligament Morphology and Rotator Cuff Tears: A Cadaveric Study

2021 ◽  
Author(s):  
Abdulrahman Alraddadi ◽  
Abduelmenem Alashkham ◽  
Clare Lamb ◽  
Roger Soames
Keyword(s):  
Rotator Cuff ◽  
Cadaveric Study ◽  
Rotator Cuff Tears ◽  
Coracoacromial Ligament

ABDUCTION MOMENT ARMS OF ROTATOR CUFF TENDONS AND DELTOID MUSCLES AFTER ACROMIOPLASTY AND CORACOACROMIAL LIGAMENT SECTION

2002 ◽  
Vol 06 (03n04) ◽  
pp. 147-156 ◽  
Author(s):  
T. Nakajima ◽  
J. Liu ◽  
Kai-Nan An
Keyword(s):  
Rotator Cuff ◽  
Deltoid Muscle ◽  
Supraspinatus Tendon ◽  
Abduction Angle ◽  
Coracoacromial Ligament ◽  
Magnetic Tracking ◽  
Moment Arms ◽  
Tracking Device ◽  
Tendon Excursion

Scientifically, it has been questioned if the coracoacromial ligament has a significant role of serving as a pulley for the supraspinatus tendon. The purpose of this study was to examine the changes of abduction moment arms of the rotator cuff and deltoid muscle after anterior acromioplasty. In normal condition and after sectioning of the coracoacromial ligament and acromioplasty, abduction moment arms of four cuff tendons and three portions of the deltoid were obtained with four cadaver shoulders by computing the slope of the tendon excursion versus the glenohumeral abduction angle curve using a magnetic tracking device. In intact joints, the abduction moment arms of the supraspinatus increased from 20 mm to 27 mm with the arm abducted from 0° to 30°, which showed a better condition of the glenohumeral abduction. Then, they decreased to 23 mm with arm in 60° abduction. After sectioning of the coracoacromial ligament and acromioplasty less than 4 mm thick, the abduction moment arms of supraspinatus did not increase. This finding suggested that the coracoacromial ligament and acromion, anatomically, did not serve as pulleys for the supraspinatus tendon. However, the abduction moment arm of the middle deltoid decreased after an acromioplasty.

Release and reattachment of the coracoacromial ligament: A cadaveric study

1997 ◽  
Vol 6 (3) ◽  
pp. 297-305 ◽  
Author(s):  
Benjamin Shaffer ◽  
Brian Evans ◽  
Gregg Ferrero
Keyword(s):  
Cadaveric Study ◽  
Coracoacromial Ligament
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