Subcoracoid impingement occurs when the subscapularis tendon becomes impinged between the coracoid process and the lesser tuberosity. It can be caused by anatomical variants that reduce the coracoglenoid space. Patients experience anterior shoulder pain that is diagnosed using tests like the lift-off and Napoleon tests as well as MRI. Treatment options include rest, anti-inflammatories, rehabilitation, arthroscopic coracoplasty through the rotator interval or open surgery to widen the space.

1. Subcoracoid impingement Dr. E. Galindo

5. Lift-off test*. Diagnosis: * Burkhart SS, Tehrany AM. Arthroscopic subscapularis tendon repair: Technique and preliminar results. Arthroscopy. 2002 May-Jun;18(5):454-63.

8. M.R.I. (axial) Diagnosis:

9. Fisiopathology: Narrow space Roller-Wringer Inflamation Tendinitis TUFF Subscapularis Rupture

10. The Roller-Wringer effect * Burkhart SS, Ian K, Lo. The etiology and assessment of subscapularis tendon tears: the Roller-Wringer effect, and TUFF lesions of subscapularis. Arthroscopy. 2003 Dec;19(10):1142-1150. Fisiopathology:

11. * Burkhart SS, Ian K, Lo. The etiology and assessment of subscapularis tendon tears: the Roller-Wringer effect, and TUFF lesions of subscapularis. Arthroscopy. 2003 Dec;19(10):1142-1150. Fisiopathology: The Roller-Wringer effect

12. TUFF lesion (Tensile undersurface fiber failure) * Burkhart SS, Ian K, Lo. The etiology and assessment of subscapularis tendon tears: the Roller-Wringer effect, and TUFF lesions of subscapularis. Arthroscopy. 2003 Dec;19(10):1142-1150. Fisiopathology:

22. VAP ® Surgical technique:

23. Surgical technique: VAP ®

24. Conjoined tendon Surgical technique:

25. Coracoplasty Surgical technique:

26. Surgical technique: Coracoplasty

27. Measurement of the new space. Surgical technique:

30. Many thank’s !!!