Coracoid process fracture

Last revised by Dr Henry Knipe on 17 Sep 2020

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 fracture, as well as glenohumeral dislocation or acromioclavicular joint injury.

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

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

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.

  • 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

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3: avulsion of coracobrachialis
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  • Case 4
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  • Case 5: with bony Bankart lesion
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  • Case 6: on 3D CT
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  • Case 6: on x-ray
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