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Coracoid Avulsion Fracture
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Contents
Other Names
- Coracoid Process Avulsion Fracture
- Pediatric Coracoid Process Fracture
Background
- This page refers to fractures of the base of the Coracoid Process seen in pediatrics
- Most commonly presenting as an avulsion injury
Epidemiology
- Overall, coracoid process fractures are rare
- Pediatric coracoid process fractures
- Rare, incidence and prevalence unknown
Pathophysiology
- Overall, poorly understood or described in the literature
- Case reports generally endorse significant direct trauma from sports
Osteology
- Coracoid Process begins ossifying at 3 months[2]
- Physis at the tip of the coracoid (fuses at 18-25 years old)
- Physis at the base of the coracoid (appears at age 8-10, fuses by age 14-16 years old)
Associated Injuries
Pathoanatomy
- Coracoid Process represents an anterior project of the Scapula
- Attachments
- Laterally: Biceps Brachii, Coracobrachialis
- Medially: Pectoralis Minor
- Ligaments: Coracoclavicular Ligaments, Coracoacromial Ligaments
Risk Factors
Differential Diagnosis
- Fractures
- Proximal Humerus Fracture
- Humeral Shaft Fracture
- Clavicle Fracture
- Scapula Fracture
- First Rib Fracture (traumatic or atraumatic)
- Dislocations & Separations
- Arthropathies
- Muscle & Tendon Injuries
- Rotator Cuff
- Bursopathies
- Ligament Injuries
- Neuropathies
- Other
- Pediatrics
- Coracoid Avulsion Fracture
- Humeral Head Epiphysiolysis (Little League Shoulder)
Clinical Features
- General: Physical Exam Shoulder
- History
- Patients typically endorse direct trauma to the anterior shoulder
- Physical Exam
- Isolated tenderness over the coracoid process
- Restricted range of motion
Evaluation
Radiographs
- Standard Radiographs Shoulder initially
- Can demonstrate fracture of base of coracoid process
- Best seen on axillary view?
MRI
- Utility unclear
- Useful to evaluate other soft tissue injuries
CT
- Useful to clarify osseus injuries
Classification
- N/A
Management
Prognosis
- Minimal data to guide decision making or prognosis
- Management options based on case reports
Nonoperative
- Indications unclear
- Likely non-displaced fractures
- Consider immobilization in Abduction Brace for 6 weeks
Operative
- Indications unclear
Rehab and Return to Play
Rehabilitation
- Needs to be updated
Return to Play
- In one case report, athlete made a full recovery at 8 weeks and return to play at 12 weeks[3]
Complications
- Inability to return to sport
See Also
- Internal
- External
- Sports Medicine Review Shoulder Pain: https://www.sportsmedreview.com/by-joint/shoulder/
References
- ↑ McGINNIS, M. A. R. K., and JOHN R. Denton. "Fractures of the scapula: a retrospective study of 40 fractured scapulae." The Journal of trauma 29.11 (1989): 1488-1493.
- ↑ Delgado, Jorge, Diego Jaramillo, and Nancy A. Chauvin. "Imaging the injured pediatric athlete: upper extremity." Radiographics 36.6 (2016): 1672-1687.
- ↑ 3.0 3.1 Pedersen, Vera, et al. "Non-operative treatment of a fracture to the coracoid process with acromioclavicular dislocation in an adolescent." Orthopedic reviews 6.3 (2014).
- ↑ Chitre, Amol R., et al. "Traumatic isolated coracoid fractures in the adolescent." Case reports in orthopedics 2012 (2012).
- ↑ Alsey, Karl J., Anant N. Mahapatra, and Julian H. Jessop. "Coracoid fracture in an adolescent rugby player–Case report and review of the literature." Radiography 18.4 (2012): 301-302.
Created by:
John Kiel on 4 July 2019 08:46:57
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Last edited:
1 October 2022 19:15:49
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