Coracoid process fracture

Coracoid process fractures are an uncommon type of scapular fracture. They do not often occur in isolation and are often associated with acromial, clavicular, or other scapular fractures, as well as glenohumeral dislocation or acromioclavicular joint injury.

Epidemiology

Coracoid fractures represent <1% of all fractures and ~7.5% (range 2-13%) of scapular fractures ¹.

Pathology

In general, the coracoid process tends to fracture at its base and be minimally displaced. They have been divided into two types:

• type I: fracture proximal to the coracoclavicular ligament

• type II: fracture distal to the coracoclavicular ligament

Treatment and prognosis

Since the coracoid process is important as a stabilizer for many shoulder movements, surgical management may be necessary for displaced fractures to avoid a painful nonunion ².

Practical points

• the physis at the tip of the coracoid normally fuses at 18-25 years old

• the physis at the base of the coracoid normally fuses by age 14-16 years old, but before this time it extends into the superior glenoid and can mimic a fracture