Medial coracoclavicular ligament revisited: an anatomic study and review of the literature

Abstract

The medial coracoclavicular ligament (MCCL), up to now rarely reported in the literature, was studied in a formol-fixed cadaver by means of dissection, morphometry, and light microscopy. This entity represents a true ligament within the coracoclavicular fascia. Although longer and narrower than its lateral counterpart, the medial coracoclavicular ligament follows the same morphological pattern, including the cartilage at the level of the coracoidal attachment. Its clinical significance and implications together with a review of the literature is presented.

The medial coracoclavicular ligament: anatomy, biomechanics,and clinical relevance—a research study

“…Our biomechanical findings are consistent with the histologic description by Stimec et al 35 . These authors describe a central area of parallel collagen-fiber bundles and the presence of cartilage at the coracoid attachment.…”

“…Blandin, 3 Cruveilhier, 8 Henle, 15 Paturet, 21 and Poirier et al 22 alternately described the MCCL as a fibrous formation with a medial insertion on the clavicle merging with the anterior sheath of the subclavius muscle fascia. Several authors 3 , 4 , 6 , 8 , 10 , 15 , 22, 23, 24, 25, 26, 27 , 33 , 35 , 37 , 41 consider that the ligament is not dependent on the neighboring structures. Among them, Poitevin et al 27 made a detailed description of the anatomic arrangement of the MCCL.…”

“…The MCCL has been described as "an organ having an imprecise function. " 33 However, some anatomic and histologic studies define it as a true ligament in relation to the coracoclavicular fascia and with a morphologic pattern that mimics its lateral counterpart 7, 35. Even its location is consistent with its possible ligamentary function 7…”

“…These authors describe a central area of parallel collagen-fiber bundles and the presence of cartilage at the coracoid attachment. Its small diameter is compensated for by the torsion of its fibers in the middle third, which significantly increases its tensile strength 35 . These histologic features show an adaptation to the compressive and shear forces 19 …”

Anatomie der akromiokorakoklavikulären Region

“…Eine ähnliche Beschreibung wurde dem kostokorakoidalen Faserzug, einer Faszienverstärkung zwischen der ersten Rippe und dem Processus coracoideus zugewiesen. Teile der klavipektoralen Faszie werden auch als kostokorakoidale Membran und als korakoklavikuläre Faszie bezeichnet [40].…”