Anatomy:

• coracoid process can be palpated thru anterior deltoid muscle one to two finger breadths below outer portion of clavicle;
• one finger breadth lateral to coracoid is the GHJ;
• provides a palpable guide to deltopectoral groove;
• serves as an anchor for coracoid muscles (coracobrachialis & short head of biceps) that separate lateral safe side from medial side where brachial plexus and vessels lie;
• clavipectoral fascia covers the floor of deltopectoral groove and is identified by rotating humerus;
  • this allows subscapularis to be identified beneath fascial layer;

Role of CA Ligament:

• attaches to front and undersurface of acromion as a thick band and continues around anterolateral corner to attach to lateral ridge for a variable distance.
• anteriorly, the coracoacromial ligament attaches to the anterior inferior edge of the acromion, while the deltoid fascia attaches more superiorly;
• up to 15 mm of motion may occur between the acromion and the coracoid, when subjected to a 30 kg distractive force;

References:

• The structure of the coracoacromial ligament: fibrocartilage differentiation does not necessarily mean pathology
• Effect of coracoacromial ligament resection on glenohumeral stability under active muscle loading in an in vitro model.
• Anatomy of the coracoacromial veil.
• Release of the coracoacromial ligament can lead to glenohumeral laxity: a biomechanical study.
• The effect of coracoacromial ligament excision and acromioplasty on superior and anterosuperior glenohumeral stability.

• Coracoid process transfer for acromioclavicular dislocations. A report of 20 cases.
• The role of the coracoid process in the chronic impingement syndrome.
• Surgery about the coracoid: neurovascular structures at risk
• Biomechanics of coracoacromial arch modification
• The relation of the coracoid process to the glenoid: an anatomic study.
• Arthroscopic coracoplasty through the rotator interval