Subacute Acromioclavicular Dislocation After Basal Coracoid Process Fracture: Indirect Reduction without Open Reduction and Internal Fixation

Abstract

Case: A 55-year-old man presented with an isolated undisplaced basal coracoid process (CP) fracture after direct trauma over his right shoulder. One week later, he presented with pain and anatomical deformity over the acromioclavicular joint (ACJ). Shoulder x-rays and computerized tomography revealed a complete acromioclavicular (AC) dislocation and displaced CP fracture. Anatomical AC reduction and ipsilateral coracoid fracture reduction were obtained using fixation with a hook plate. At 12-month follow-up, the patient regained functionality and showed complete CP consolidation and anatomic alignment of the ACJ. Conclusion: Our alternative treatment of coracoid fracture associated with secondary subacute AC dislocation showed satisfactory functional results.

Treatment of acromioclavicular dislocations with a concomitant coracoid fracture: a systematic review of 37 patients

“…We included 20 articles describing 22 patients who were treated surgically. [1][2][3][4][9][10][11][12][16][17][18][19]22,29,30,36,37,40,41 Twelve patients (55%) underwent fixation of both the AC joint and the CP, 2,3,9,11,[16][17][18]22,29,30,40,41 9 patients (41%) had a sole fixation of the AC joint, 1,4,10,12,19,36,37 and 1 patient (5%) was treated with a sole fixation of the CP 25 (Table II). The most frequently used methods for fixation of the AC joint included the use of a clavicular hook plate and K-wires.…”

“…29,35 Some studies suggest that surgeons should opt for a nonsurgical approach, 3,22,35 whereas others advise surgical treatment with either a fixation of both the AC joint and the CP, 19 or a sole fixation of the AC joint. 1,12,19 This systematic review was performed to address the clinically relevant question: what are the shoulder functions, union rates, and expected time until return to daily life in patients with a dislocation of the AC joint with a concomitant CP fracture after (1) nonsurgical treatment, (2) sole fixation of the AC joint, and (3) fixation of both the AC joint and the coracoid process?…”