Anatomic Morphometry of the Coracoid Process and Lateral Clavicle for Management of Glenoid Bone Loss: A 3-Dimensional Analysis in a Korean Population

Abstract

Background: Proper sizing of the coracoid is an important factor when using the Latarjet procedure. However, several studies have reported that the Asian coracoid may not be large enough for the Latarjet. A distal clavicle has recently been suggested as a locally available osteoarticular graft for restoring glenoid bone loss. The objective of this study was to examine the anatomic morphometry of the coracoid and distal clavicle in the Korean population. Methods: A total of 66 cadaveric coracoids and clavicles (32 men and 34 women) underwent continuous 1.0-mm slice computed tomography (CT) scans. CT images were imported into Mimics software for reconstruction of a 3-dimensional model of the coracoid process and clavicle. The length, width, and height of the coracoid process were measured. In addition, the width and height within 10 mm of the lateral end of the clavicle were also measured. Analysis of correlation between measured parameters and demographics data was performed. Results: The mean length of the coracoid was 19.2 ± 2.0 mm, the width of the coracoid was 15.5 ± 1.7 mm, and the height of the coracoid was 11.5 ± 1.6 mm. The width and height of the 10 mm point of the clavicle were 22.1 ± 3.7 mm and 12.0 ± 1.8 mm, respectively. The results showed that women had smaller measurements than men in all parameters (p < 0.05). Height showed a significant positive correlation with all measured parameters (p < 0.05). An equation for estimating the coracoid length using these findings was as follows: coracoid length (mm) = 11.70 + (0.041 height) + 1.86 (the last number was added for men); the width at the 10 mm point of the clavicle = 0.16 × height + 3.18 (the last number was added for men). Conclusions: The morphologies of the coracoid process and the distal clavicle showed significant correlations with sex and height. The coracoid length tends to be smaller in Asians than Caucasians, thus, the distal clavicle might be a suitable option for reconstruction of instability-related glenoid bone loss in the Asian population.