Scapular process fractures
Types
Coracoid process
Scapula spine
Acromial fractures
Coracoid process fracture
Classification
Ogawa
- Type I: Anterior to CC ligaments
- Type II: Posterior to CC ligaments
Injury patterns
- systematic review of 197% coracoid process fractures
- 77% Type I
- 76% had associated shoulder girdle fractures / disruption superior shoulder suspensory complex (SSSC)
- ACJ injury / clavicle # / acromial # / scapular spine # / anterior shoulder instability
Indications for surgery
Floating shoulder / disruption SSSC - AC joint dislocation / clavicle fractures
Displacement > 1 cm
Nonoperative management
Ogawa et al Arch Orthop Trauma Surg 2021
- systematic review of 30 coracoid nonunions
- 12 type 1 and 18 type II
- only 6 were isolated injuries
- most symptoms minimal
Operative management Type I
AO Surgical foundation coracoid process ORIF
Tuor et al Sage Open Medical 2023
- 5 cases of surgical fixation of Type I coracoid with screws
- indicated with concomitant shoulder injury
- disruption of the superior shoulder suspensory complex / floating shoulder
Operative management Type II
Xie et al BMC Musculoskelet 2024
- technique of arthroscopic assist screw fixation Type II coracoid fracture
Scapular spine
