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Coracoid Avulsion Fracture

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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
    • Account for 13% of Scapula fractures, between 5-10% of all fractures of the shoulder girdle[1]
  • 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


Risk Factors


Differential Diagnosis


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

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


References


  1. 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.
  2. Delgado, Jorge, Diego Jaramillo, and Nancy A. Chauvin. "Imaging the injured pediatric athlete: upper extremity." Radiographics 36.6 (2016): 1672-1687.
  3. 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).
  4. Chitre, Amol R., et al. "Traumatic isolated coracoid fractures in the adolescent." Case reports in orthopedics 2012 (2012).
  5. 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
Authors:
Last edited:
13 November 2020 14:19:24