The conoid ligament is the posterior, cone-shaped component of the coracoclavicular ligament complex, providing the primary resistance against superior clavicular displacement. It is the more important of the two CC ligaments for vertical AC joint stability. Its anatomy — passing nearly vertically from the coracoid knee to the conoid tubercle — makes it more effective against superior clavicular forces than the horizontally-oriented trapezoid.
| Origin | Knee of the coracoid process (base, posterior) |
|---|---|
| Insertion | Conoid tubercle of the inferior clavicle (more medial than the trapezoid) |
| Actions | Primary restraint against superior clavicular displacement; the more medial and stronger coracoclavicular component |
|---|
Radiographic measurement of the CC distance (normally 11-13 mm) assesses conoid and trapezoid ligament integrity. An increased CC distance of >50% compared to the contralateral side indicates complete CC ligament disruption. Anatomical CC ligament reconstruction places a conoid graft medially and a trapezoid graft laterally through separate bone tunnels.
Combined conoid and trapezoid rupture increasing CC distance on radiograph managed with reconstruction for symptomatic high-grade AC separations.
