Coracoid fracture combined with distal clavicle fracture without coracoclavicular ligament rupture: A case report

Abstract

Distal clavicle fracture accompanied by coracoid process one is a rare injury. Surgical and/or conservative treatments are proposed. We report the case of a 49-year-old woman presenting a distal clavicle fracture associated with a coracoid process one due to a fall on the left shoulder. Both injuries are treated surgically. Per operatively, and through an anterior "strap" approach, the coracoclavicular ligament was seen intact. The distal clavicle fracture was fixed with K-wires and cerclage and the coracoid process was secured by a screw. Active-assisted rehabilitation of the shoulder was initiated 3 weeks after surgery. At the last follow-up of twelve months, the patient had painless full shoulder functions and X-rays show bony union. Early recovery to normal life is possible with surgical treatment in patients with distal clavicle fracture combined with coracoid fracture.

Ipsilateral distal clavicle and coracoid base physeal fractures in a skeletally immature athlete: a case report

“…The few reports in the literature of the simultaneous occurrence of ipsilateral distal clavicle and coracoid fractures have only been reported in adults 2,7,13,14 . To the best of our knowledge, our patient is the first report of this injury pattern in the skeletally immature.…”

“…Coracoid process fractures occur infrequently 2,[6][7][8]10,13 and are often associated with other shoulder girdle injuries 2,10,13 . In the growing skeleton, the most common location of coracoid injury occurs at the physeal base 4,6,10 .…”

“…Though the simultaneous occurrence of distal clavicle and coracoid process fractures is rare, the incidence of this combined injury may be underreported as coracoid process fractures can easily be missed on routine radiographs 2,7,10,13 . In the skeletally immature, the detection of coracoid process fractures is of heightened difficulty due to the presence of the physis 2 . Special attention should be paid to coracoid process physeal widening and irregularity on radiographs 1 .…”

“…Isolated distal clavicle 3,5,9,12 and coracoid process 2,7,10,13 fractures rarely occur in the skeletally immature. In this population, the simultaneous ipsilateral occurrence of these fractures occurs even less frequently, with the only known reports of this injury profile occurring in adults 2,7,13,14 . Two mentions of coracoid process fractures with associated AC dislocations exist in the literature, one of which was reported in a child 6 while the other was described in an adult 8 .…”

Superior shoulder suspensory complex fracture dislocation case report

“…It has been suggested that most Rockwood type III ACJ dislocations can be treated conservatively, with sling immobilisation and pain control, and still obtain good functional results. However, for ACJ dislocation and coracoid process fractures, if the arm is used above the horizontal plane, in active young patients or in severe displacement, surgery may be preferential to prevent cosmetic deformity and reduced function 6,11 . Literature regarding surgical management of coracoid process fractures is uncommon and largely consists of lower quality evidence such as case reports 2 .…”