Evaluation, Management and outcomes of the fractures with C
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Coracoid process fractures are relatively rare and typically occur because of high-energy trauma. Thus, most coracoid fractures occur in conjunction with other shoulder injuries, including dislocations and fractures. Careful clinical evaluation including imaging of the affected shoulder is essential because the presence of concomitant injuries may affect treatment decision-making. MRI or CT with 3-D reconstruction is important to define fracture displacement and morphology.

The most common combination of coracoid fracture with AC joint injury may present with additional findings of pain and tenderness to palpation over the AC joint, visible deformity, and painful cross-body adduction.

Management is largely dictated by fracture location and displacement. Conservative treatment is preferred for fractures that are minimally displaced and may even be successfully used in displaced fractures closer to the tip of the coracoid (Eyres I, II,& III). Surgical fixation is indicated for coracoid fractures associated with an unstable SSSC (superior shoulder suspensory complex), displaced extension into either the scapula body or glenoid fossa, or progression into a painful nonunion. Although conservative treatment has been historically favored, satisfactory outcomes have been reported for both surgical and nonsurgical treatment.

The decision between conservative or surgical intervention should be a shared decision between the patient and the surgeon based on the fracture pattern, associated shoulder injuries, patient’s activity or sporting level, and their expectations.

Source: https://journals.lww.com/jaaos/Abstract/2020/08150/Fractures_of_the_Coracoid_Process__Evaluation,.4.aspx?c