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Isolated Fracture of the Coracoid Process

DOI: 10.1155/2014/482130

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Abstract:

Coracoid fractures are rarely seen fractures. In the shoulder girdle, coracoid process fractures generally accompany dislocation of the acromioclavicular joint or glenohumeral joint, scapula corpus, clavicula, humerus fracture, or rotator cuff tear. Coracoid fractures can be missed and the treatment for coracoid process fractures is still controversial. In this paper, a 34-year-old male manual labourer presented to the emergency department with complaints of pain and restricted movement in the left shoulder following a traffic accident. On direct radiographs and computerised tomography images a fragmented fracture was observed on the base of the coracoid process. In addition to the coracoid fracture, a mandibular fracture was determined. The patient was admitted for surgery on both fractures. After open reduction, fixation was made with a 3.5?mm cannulated screw and washer. At the postoperative 6th week, bone union was determined. The patient returned to his previous occupation pain-free and with a full range of joint movement. In conclusion, in the current case of isolated fragmented coracoid process fracture showing minimal displacement in a patient engaged in heavy manual work, surgery was preferred as it was thought that nonunion might be encountered particularly because of the effect of forces around the coracoid. 1. Introduction Coracoid fractures are rarely seen fractures [1]. In the shoulder girdle, coracoid process fractures generally accompany dislocation of the acromioclavicular (AC) joint or glenohumeral joint, scapula corpus fracture, clavicular fracture, humerus proximal end fracture, or rotator cuff tear [2]. Coracoid fractures can be missed and the treatment for coracoid process fractures is still controversial. The case presented here is of an isolated coracoid process fracture treated surgically. 2. Case Report A 34-year-old male manual labourer presented at the Emergency Department with complaints of pain and restricted movement in the left shoulder following a traffic accident. In the physical examination, ecchymosis and sensitivity in the left shoulder, restricted shoulder movements, and sensitivity in the jaw were determined. The results of the neurovascular examination were normal. On direct radiographs and computerised tomography (CT) images a fragmented fracture was observed on the base of the coracoid process (Figures 1 and 2). In addition to the coracoid fracture, a mandibular fracture was determined. The patient was admitted for surgery on both fractures. After making the incision along the Langer’s line on the coracoid

References

[1]  O. H. Petty, “Fracture of the coracoid process of the scapula caused by muscular action,” Annals of Surgery, vol. 45, no. 3, pp. 427–430, 1907.
[2]  K. Ogawa, A. Yoshida, M. Takahashi, and M. Ui, “Fractures of the coracoid process,” Journal of Bone and Joint Surgery B, vol. 79, no. 1, pp. 17–19, 1997.
[3]  J. R. Ada and M. E. Miller, “Scapular fractures: analysis of 113 cases,” Clinical Orthopaedics and Related Research, no. 269, pp. 174–180, 1991.
[4]  R. J. Imatani, “Fractures of the scapula: a review of 53 fractures,” Journal of Trauma, vol. 15, no. 6, pp. 473–478, 1975.
[5]  M. C. Wilber and E. B. Evans, “Fractures of the scapula. An analysis of forty cases and a review of the literature,” Journal of Bone and Joint Surgery A, vol. 59, no. 3, pp. 358–362, 1977.
[6]  K. P. Butters, “Fractures and dislocations of the scapula,” in Fractures in Adults, C. A. Rockwood Jr., D. P. Green, R. W. Bucholz, and J. D. Heckman, Eds., pp. 1163–1164, Lippincott-Raven, Philadephia, Pa, USA, 4th edition, 1996.
[7]  E. Vaienti and F. Pogliacomi, “Delayed diagnosis of isolated coracoid process fractures: results of 9 cases treated conservatively,” Acta Biomedica, vol. 83, no. 2, pp. 138–146, 2012.
[8]  H. Lal, P. Bansal, V. K. Sabharwal, L. Mawia, and D. Mittal, “Recurrent shoulder dislocations secondary to coracoid process fracture: a case report,” Journal of Orthopaedic Surgery, vol. 20, no. 1, pp. 121–125, 2012.
[9]  R. Botchu, K. J. Lee, and S. Bianchi, “Radiographically undetected coracoid fractures diagnosed by sonography. Report of seven cases,” Skeletal Radiology, vol. 41, no. 6, pp. 693–698, 2012.
[10]  C. S. Neer II, “Fractures about the shoulder,” in Fractures, C. A. Rockwood and D. P. Green, Eds., pp. 713–721, Lippincott, Philadephia, Pa, USA, 1984.
[11]  J. Anavian, C. A. Wijdicks, L. K. Schroder, S. Vang, and P. A. Cole, “Surgery for scapula process fractures: good outcome in 26 patients,” Acta Orthopaedica, vol. 80, no. 3, pp. 344–350, 2009.
[12]  C. Spormann, P. Holzach, and C. Ryf, “Open reduction and internal fixation of isolated fractures of the coracoid-process—presentation of three cases and review of the literature,” Swiss Surgery, vol. 4, no. 4, pp. 198–202, 1998.
[13]  A. S. Subramanian, M. A. Khalik, and M. M. Shah, “Isolated fracture of the coracoid process associated with unstable shoulder,” ANZ Journal of Surgery, vol. 77, no. 3, pp. 188–189, 2007.
[14]  M. Garcia-Elias and J. M. Salo, “Non-union of a fractured coracoid process after dislocation of the shoulder. A case report,” Journal of Bone and Joint Surgery B, vol. 67, no. 5, pp. 722–723, 1985.
[15]  I. J. Guttentag and G. R. Rechtine, “Fractures of the scapula. A review of the literature,” Orthopaedic Review, vol. 17, no. 2, pp. 147–158, 1988.
[16]  T. P. Goss, “The scapula: coracoid, acromial, and avulsion fractures,” American Journal of Orthopedics, vol. 25, no. 2, pp. 106–115, 1996.
[17]  D. N. Bhatia, “Orthogonal biplanar fluoroscopy-guided percutaneous fixation of a coracoid base fracture associated with acromioclavicular joint dislocation,” Techniques in Hand and Upper Extremity Surgery, vol. 16, no. 1, pp. 56–59, 2012.

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