From the Guidelines
Surgical intervention is usually the treatment for coracoid fractures, but simple immobilization is appropriate when fracture fragments are small, nonarticular, or minimally displaced. Management of coracoid fractures should prioritize the patient's quality of life and minimize morbidity and mortality.
Key Considerations
- The diagnosis of coracoid fractures is based on a history of trauma and focal pain on palpation, confirmed with radiographic studies 1.
- The treatment approach depends on the severity and displacement of the fracture.
- For small, nonarticular, or minimally displaced fractures, immobilization is a suitable option.
Treatment Approach
- Immobilization is recommended for patients with small, nonarticular, or minimally displaced fracture fragments.
- Surgical intervention may be necessary for more complex or displaced fractures.
- The goal of treatment is to promote healing, reduce pain, and restore function, ultimately improving the patient's quality of life.
Rehabilitation
- After the initial treatment period, a progressive rehabilitation program should be initiated to promote healing and restore function.
- The rehabilitation program should include gentle exercises and gradual progression to more strenuous activities.
- The treatment approach should be individualized based on the patient's specific needs and circumstances, prioritizing their quality of life and minimizing morbidity and mortality.
From the Research
Corcoid Fracture Management
- Corcoid fractures are relatively rare and often occur in conjunction with other shoulder injuries, making diagnosis challenging 2.
- Management of corcoid fractures is guided by fracture location and displacement, with conservative treatment preferred for minimally displaced fractures and surgical fixation indicated for displaced fractures (>1 cm) or those with associated disruptions of the superior shoulder suspensory complex 2, 3.
Treatment Options
- Conservative treatment has been shown to yield good results in most Ogawa type II fractures and type I fractures without associated disruptions of the SSSC 3.
- Surgical treatment may be considered in Ogawa type I fractures with multiple disruptions of the SSSC, and has been shown to provide good results in these cases 3, 4.
- Arthroscopic internal fixation is a viable option for corcoid fractures, particularly in cases of nonunion or complex fractures 5.
Surgical Techniques
- Open reduction and internal fixation with a cannulated screw and washer is a common surgical approach for isolated corcoid fractures 6.
- A direct approach through Langer's lines or an anterior approach can be used for surgical management of corcoid fractures, depending on the location and complexity of the fracture 4.
- Implant selection should be based on the size of the fragment, degree of comminution, and degree of articular involvement to ensure adequate stabilization 4.