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Anatomical variations of the acromial and coracoid process: clinical relevance

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Abstract

Purpose

The acromial and coracoid process morphology is of clinical relevance due to associations with functional limitations and shoulder pathology. Our objective was to describe the anatomical characteristics of the acromial and coracoid process using computed tomography (CT).

Methods

Descriptive, observational, transversal and retrospective study. A total of 155 CT of patients without shoulder pathology, of both genders, and indistinct age were evaluated and grouped by age: Group 1 < 25 years; group 2 25–40 years; group 3 > 40 years. The following parameters were evaluated: Acromial type (AcT), vertical coracoid distance (VCD), acromial tilt (AT), acromial projection (AP), critical shoulder angle (CSA), type of the subcoracoid outlet (TSO), and the area of the subcoracoid outlet (ASO).

Results

Statistically significant differences were found between men and women for VCD (14.44 ± 4.79 vs. 11.76 ± 4.00 mm; p < 0.001) and AP (3.66 ± 4.71 vs. 1.62 ± 4.99 mm; p < 0.05) as well as between age groups 1 and 3 for AT (35.08 ± 11.53 vs. 28.41 ± 6.60; p < 0.05) and ASO (398.99 ± 153.91 vs. 255.56 ± 124.58 mm2; p < 0.001). An unexpected high ASO variation was identified with 11% of S-shaped acromion and 1.3% clock-shaped TSO.

Conclusion

The age group between 25–40 years had the most uniform distribution of data. There is a high morphological variability present in an asymptomatic population, which should be considered in the clinical assessment such as shoulder impingement syndrome.

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Acknowledgements

We thank Armando Gibran Franco Salazar for the help with the design of the images and Francisco Jesús Barrera Flores & Juan Manuel Millán Flores for the help in the sample size calculation and statistical analysis.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Human Anatomy Department, School of Medicine, Universidad Autonoma de Nuevo Leon, Ave. Madero y Dr. Aguirre Pequeño s/n, Col. Mitras Centro, CP. 64460, Monterrey, Nuevo León, Mexico

    Uriel Alfaro-Gomez, Luis Donaldo Fuentes-Ramirez, Rodrigo E. Elizondo-Omana, Santos Guzman-Lopez & Alejandro Quiroga-Garza

  2. Department of Radiology and Diagnostic Imaging, Universidad Autonoma de Nuevo Leon, Hospital Universitario “Dr. José Eleuterio González”, Monterrey, Nuevo Leon, Mexico

    Karla Ivonne Chavez-Blanco, Jesus Dante Guerra-Leal, Guillermo Elizondo-Riojas & Ricardo Pinales-Razo

  3. Department of Traumatology and Orthopedics, Universidad Autonoma de Nuevo Leon, Hospital Universitario “Dr. José Eleuterio González”, Monterrey, Nuevo Leon, Mexico

    Jose Felix Vilchez-Cavazos

  4. Department of Biological Sciences, West Liberty University, West Liberty, WV, USA

    Matthew J. Zdilla

  5. Department of Graduate Health Sciences, West Liberty University, West Liberty, WV, USA

    Matthew J. Zdilla

  6. Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University School of Medicine, Morgantown, WV, USA

    Matthew J. Zdilla

Authors
  1. Uriel Alfaro-Gomez
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  2. Luis Donaldo Fuentes-Ramirez
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  3. Karla Ivonne Chavez-Blanco
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  4. Jose Felix Vilchez-Cavazos
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  5. Matthew J. Zdilla
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  6. Rodrigo E. Elizondo-Omana
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  7. Jesus Dante Guerra-Leal
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  8. Guillermo Elizondo-Riojas
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  9. Ricardo Pinales-Razo
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  10. Santos Guzman-Lopez
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  11. Alejandro Quiroga-Garza
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Contributions

UA-G, AQ-G: conceptualization, project development, data collection/management, data analysis, manuscript writing, and manuscript editing. LDF-R, JDG-L: data collection/management, and data analysis. KIC-B: project development, data collection/management, data analysis. JFV-C: conceptualization, project development, and manuscript editing. MJZ: data analysis and manuscript editing. REE-O, GE-R, SG-L: project development, data analysis, and manuscript editing. RP-R: project development, data collection/management, and manuscript editing.

Corresponding author

Correspondence to Alejandro Quiroga-Garza.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The protocol was previously reviewed and approved by the University’s Ethics and Research Committees with the registration number AH17-00005. None of the imaging studies were performed for the purpose of this study.

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Alfaro-Gomez, U., Fuentes-Ramirez, L.D., Chavez-Blanco, K.I. et al. Anatomical variations of the acromial and coracoid process: clinical relevance. Surg Radiol Anat 42, 877–885 (2020). https://doi.org/10.1007/s00276-020-02497-5

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