Arthroscopic Management of a Coracoid Fracture Associated With Acromioclavicular Dislocation: Technical Note

Abstract

Operative management of a coracoid process fracture is indicated in case of painful nonunion, displacement of more than 1 cm, or multiple disruptions of the superior shoulder suspensory complex. Several techniques have been described with open reduction of the fracture and internal fixation using cortical screws with or without additional fixation of the acromioclavicular joint. This Technical Note aims to introduce an alternative safe, minimally invasive method for arthroscopic fixation of a coracoid fracture with simultaneously reduction of the acromioclavicular joint. The described arthroscopic technique might be helpful for shoulder surgeons who want to fix the coracoid process while avoiding the disadvantages of an open approach.

Surgical management of multiple superior shoulder suspensory complex disruptions involving at least a coracoid fracture and an acromioclavicular dislocation: A report of five cases

“… 22 If CP fracture occurs with an AC-joint dislocation, it is possible to address CP alone or with fixation of the AC joint. 6 All our cases had a double disruption of the SSSC. The CP can be stabilized with cannulated screws.…”

“…Multiple disruptions may cause nonunion due to shoulder girdle instability. 6 Literature pertaining to these injuries and their management guidelines is lacking. A review by Kose et al 5 of 48 cases (1946–2018) found a variety of treatment options ranging from conservative management to complex surgical reconstruction and fixation.…”

Arthroscopic Internal Fixation of Coracoid Fractures: Surgical Technique Guide

“…This article demonstrates an arthroscopy-aided approach to fixing coracoid fractures. Passaplan et al 8 described an arthroscopic assisted technique for a type II fracture with simultaneous reduction of the acromioclavicular joint. The technique they describe demonstrates reduction of the base of the coracoid back to the glenoid, whereas our technique demonstrates how to arthroscopically fix a fracture distal to the CC ligaments.…”

“…To our knowledge there is only a single report of arthroscopic fixation of an Ogawa type I fracture and no reported cases of arthroscopic fixation of an Ogawa type II fracture. 8 This case will highlight the first reported use of arthroscopy to debride a Type II coracoid nonunion, as well as the use of arthroscopic assisted percutaneous fixation of a Type II coracoid fracture.…”

An innovative fixation technique by osteosuture in a young athletic female patient with coracoid process fracture: a case report

“…In 2020, Passaplan et al . describe an arthroscopic screw fixation technique [ 12 ]. The procedure is technically demanding but, it permits a very good visualization of the fracture for reduction and fixation, whereas visualization of the coracoid process remains difficult even in open procedures.…”