Treatment of coracoid process fractures: a systematic review

Doesburg, Peter G. van; Saddy, Salih El; Alta, T.D.W.; Noort, Arthur van; Bergen, Christiaan J. A. van

doi:10.1007/s00402-020-03496-2

Cited by 20 publications

(41 citation statements)

References 32 publications

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“…They considered that type I fractures indeed require operation whenever the scapuloclavicular connection has been destroyed [2]. This is consistent with many reports in the literature [1][2][3][4][5][6][7][8][9][10][11][12][13]. Within these injuries, a fracture of the coracoid process base represents a severe form of the injury, and a variety of classifications have stressed the importance of recognition of this subtype.…”

Section: Introductionsupporting

confidence: 69%

A guideline for screw fixation of coracoid process base fracture by 3D simulation

Sun

Wang

et al. 2021

J Orthop Surg Res

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Background Fractures of the base of the coracoid process are relatively rare, but an increasing number of studies have reported using screws to fix coracoid process base fractures. This study was performed to simulate the surgical procedure and obtain the ideal diameter, length, insertion point and angle of the screw from a 3-D axial perspective in Chinese patients. Methods We randomly collected right scapula computed tomography (CT) scans from 100 adults. DICOM-formatted CT scan images were imported into Mimics software. A 3D digital model of the right scapula was established. Two virtual cylinders representing two screws were placed from the top of the coracoid process to the neck of the scapula and across the base of the coracoid process to fix the base of the coracoid process. The largest secure diameters and lengths of the virtual screws were measured. The positions of the insertion points and the directions of the screws were also examined. Results The screw insertion safe zone can exhibit an irregular fusiform shape according to the reconstructed scapula model. The mean maximum diameters of the medial and lateral screws were 7.08 ± 1.19 mm and 7.34 ± 1.11 mm, respectively. The mean maximum lengths of the medial and lateral screws were 43.11 ± 6.31 mm and 48.16 ± 6.94 mm, respectively. A screw insertion corridor with a diameter of at least 4.5 mm was found in all patients. We found sex-dependent differences in the mean maximum diameters and maximum lengths of the two screws. The positions of the two insertion points were statistically different across sexes. Conclusions The study provides a valuable guideline for determining the largest secure corridor for two screws in fixing a fracture at the base of the coracoid process. For ideal screw placement, we suggest individualised preoperative 3D reconstruction simulations. Further biomechanical studies are needed to verify the function of the screws.

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Section: Introductionsupporting

confidence: 69%

A guideline for screw fixation of coracoid process base fracture by 3D simulation

Sun

Wang

et al. 2021

J Orthop Surg Res

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“…They considered that Type-I fractures indeed need operation whenever the scapuloclavicular connection have been destroyed [2]. This is consistent with many reports in the literature [1][2][3][4][5][6][7][8][9][10][11][12]22]. Within these injuries, a fracture of the coracoid process base represents a severe form of the injury, and a variety of classi cations have stressed the importance of recognition of this subtype.…”

Section: Introductionsupporting

confidence: 68%

A guideline for screw fixation of coracoid process base fracture by 3D technology

Sun

Wang

et al. 2020

Preprint

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BackgroundFractures of the base of the coracoid process are relatively rare, but an increasing number of studies have reported using screws to fix basal coracoid process fractures. This study was performed to simulate the surgical procedure and obtain the ideal diameter, length, insertion point and angle of the screw through the method of 3-D axial perspective in Chinese patients.MethodsWe randomly collected the right scapula computed tomography (CT) scans of 100 adults. DICOM-formatted CT-scan images were imported into Mimics software. The 3D digital model of the right scapula was established. Two virtual cylinders representing two screws were placed from the top of the coracoid process to the neck of the scapula and across the base of the coracoid process to fix the basal coracoid process. The largest secure diameters and lengths of the virtual screws were measured. The positions of the insertion points and the directions of the screws were also researched.ResultsThe screw insertion safe zone can exhibit an irregular fusiform shape from the reconstructed scapula model. The mean maximum diameters of the medial and lateral screws were 7.08 ± 1.19 mm and 7.34 ± 1.11 mm, respectively. The mean maximum lengths of the medial and lateral screws were 43.11 ± 6.31 mm and 48.16 ± 6.94 mm, respectively. The screw insertion corridor with a diameter of at least 4.5 mm was found in anyone. We found gender-dependent differences for the mean maximum diameters and the maximum lengths of the two screws. The positions of the two insertion points were statistically significant in different genders.ConclusionsThe study provides a valuable guideline for the largest secure corridor of two screws that fixed the fracture at the base of the coracoid process. For the ideal screw placement, we suggest an individual preoperative 3D reconstruction simulation. Further biomechanical studies are needed to verify the function of the screws.

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“…In addition, the DASH scores of the patients in the final follow-up visit at 12 months were found to be similar to that reported in the literature, and the CMS scores were found to be better, unlike the literature. [1,8,16] In the postoperative follow-up and final controls of our patients, there was no limitation in shoulder joint movements, full range of motion was achieved, and good functional and clinical outcomes were obtained.…”

Section: Discussionmentioning

confidence: 61%

“…Coracoid fractures are very rare among shoulder girdle fractures, and they occur after high-energy trauma. [1,10] As coracoid fractures are usually nondisplaced or minimally displaced, they may be overlooked on routine X-ray examinations. [10][11][12] Therefore, special direct radiograms, computed tomography and magnetic resonance imaging are frequently used in the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…

The coracoid process is an important anatomical landmark serving as an attachment site for the short head of the biceps brachii, coracobrachialis, and pectoralis minor muscles and coracoacromial, coracohumeral, trapezoid, and conoid ligaments. [1] Another important function of the coracoid process is that it contributes to the anterior superior stability of the shoulder joint by forming the coracoacromial arch and the superior shoulder suspensory complex (SSSC). [2,3] Coracoid fractures are usually associated with other fractures and dislocations of the scapula and the shoulder area, and they are occasionally observed after high-energy traumas.

…”

mentioning

confidence: 99%

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Rare coracoid fractures presenting with superior shoulder suspensory complex injury: A case series

Doğar

Dere²,

Gürbüz³

et al. 2021

Jt Dis Relat Surg

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Although coracoid fractures are rare fractures, their treatment is critical as they form the coracoacromial arch and superior shoulder suspensory complex (SSSC), which are important structures for shoulder biomechanics. In this case series, clinical, radiological, and demographic characteristics of three male patients who received treatment due to coracoid fracture presenting with traumatic injuries were discussed. The fractures were classified according to the Ogawa and Eyres classifications, and fracture fixation was achieved surgically with the cannulated screws. All patients had a right coracoid fracture. The Constant–Murley Score and the Disabilities of the Arm, Shoulder and Hand scores the patients in the final follow-up visit at 12 months were calculated. In conclusion, good clinical and functional outcomes can be achieved by anatomical reduction and fixation through surgery for displaced coracoid fractures presenting with multiple traumatic injuries located in multiple regions of the SSSC.

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Treatment of coracoid process fractures: a systematic review

Cited by 20 publications

References 32 publications

A guideline for screw fixation of coracoid process base fracture by 3D simulation

A guideline for screw fixation of coracoid process base fracture by 3D simulation

A guideline for screw fixation of coracoid process base fracture by 3D technology

Rare coracoid fractures presenting with superior shoulder suspensory complex injury: A case series

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