Coracoid fracture is a rare injury. The aim of this study is to present the demographics, clinical and radiologic characteristics, and outcomes of coracoid fracture in a cohort of 32 patients.
We queried our institutional electronic medical record database (years 2012–2020) to identify patients with coracoid fractures using specific International Classification of Disease-10 codes. Demographic data, injury details including mechanism of injury and associated injuries, imaging performed, and treatment outcomes were obtained from retrospective chart review. A radiologist reviewed all available imaging studies (radiographs/CT/MRI) and classified the fractures according to Ogawa and Eyres classifications. Missed diagnoses were determined by comparing initial imaging reports with the follow-up imaging obtained in the office.
Thirty-two patients with coracoid fractures were identified during the study period. Sixteen fractures (50%) occurred in the setting of low-energy trauma. Twelve fractures were missed on initial radiographs, and diagnosis with three-view radiographs (AP, scapular-Y and axillary) was 88% compared to 33% (p < 0.03) with two views (AP, scapular-Y). The majority of fractures were non-displaced (94%), and 56% were Ogawa Type-II fractures. Associated injuries were seen in 81% of patients. Most fractures (94%) were treated without surgery with excellent outcomes.
Coracoid fractures continue to be a rare injury. In contrast to previous studies, in this case series of 32 patients, half of the fractures were associated with low-energy trauma, which correlated with higher percentage of non-displaced fractures and Ogawa Type-II fractures. Addition of the axillary view in the trauma radiographic series significantly improved the initial fracture detection rate.
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The authors of this paper affirm that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that there were no discrepancies from the study as planned. All data generated or analyzed during this study are included in this article.
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No funding was received for conducting this study.
Conflict of interest
Dr. Joseph D. Zuckerman is a design surgeon for Exactech Inc. and receives publishing royalties from Wolters Kluwer Health, Thieme Inc., and SLACK Inc. Dr. Zuckerman is a board member of the Musculoskeletal Transplant Foundation and has stocks in Hip Innovation Technology and Apos Therapy Inc. Dr. Virk is a consultant for Exactech Inc. All other authors have no relevant financial or non-financial interests to disclose.
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Ben-Ari, E., Pines, Y., Gordon, D. et al. Radiographic and clinical characterization of coracoid fractures: a retrospective cohort analysis. Eur J Orthop Surg Traumatol (2021). https://doi.org/10.1007/s00590-021-03144-4
- Coracoid fractures
- Ogawa classification
- Eyres classification
- Acromioclavicular joint
- Avulsion fractures