Ipsilateral concomitant fractures of the clavicle and coracoid process of the scapula: incidence, characteristics, and outcomes
Abstract Background Clavicle fractures associated with ipsilateral coracoid process fractures are very rare, with limited literature reporting only a few cases. This study reports on 27 patients with ipsilateral concomitant fractures of the clavicle and coracoid process who were followed for more th...
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SpringerOpen
2025-01-01
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| Series: | Journal of Orthopaedics and Traumatology |
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| Online Access: | https://doi.org/10.1186/s10195-025-00817-2 |
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| author | Nan Zhang Guoyang Bai Xiaomin Kang Yangjun Zhu Dongxu Feng |
| author_facet | Nan Zhang Guoyang Bai Xiaomin Kang Yangjun Zhu Dongxu Feng |
| author_sort | Nan Zhang |
| collection | DOAJ |
| description | Abstract Background Clavicle fractures associated with ipsilateral coracoid process fractures are very rare, with limited literature reporting only a few cases. This study reports on 27 patients with ipsilateral concomitant fractures of the clavicle and coracoid process who were followed for more than 12 months. Material and methods This retrospective study reviewed the charts of skeletally mature patients with traumatic ipsilateral clavicle and coracoid process fractures treated at the authors’ institution. Each patient was regularly followed post-treatment. Radiographs assessed bone union and implant integrity, while clinical evaluations included the Constant–Murley score for shoulder function; disability of the arm, shoulder, and hand (DASH) questionnaire for upper limb function; and visual analog scale score for pain. Complications were also recorded. Results From October 2012 to February 2023, 40 patients were diagnosed with ipsilateral fractures of the clavicle and coracoid process of the scapula, accounting for 1.4% (40/2877) of all clavicle fractures and 5.2% (40/786) of all scapular fractures. This study included 27 patients with follow-up exceeding 12 months: 6 had medial-third clavicle fractures, 12 had middle-third fractures, and 9 had distal-third fractures. According to Eyres’ classification, the coracoid fractures included two type I, five type II, eight type III, seven type IV, and five type V fractures. Twenty-two patients received operative treatment, with clavicle fractures fixed with internal plating and 11 coracoid fractures with internal fixation. Bone union was achieved in all patients. The mean Constant–Murley score was 91.2 ± 9.4 and the mean DASH score was 6.4 ± 7.6. Five patients reported mild shoulder pain and five patients developed complications. Conclusions Ipsilateral concomitant fractures of the clavicle and coracoid process can occur at various clavicle locations, with shaft and medial fractures more common than previously thought. Displaced fractures can be effectively managed with operative treatment, and coracoid process fixation may not be necessary if satisfactory indirect reduction is achieved after clavicle fixation. Level of evidence: Level III, retrospective cohort study. |
| format | Article |
| id | doaj-art-44002ac776f44868a01a4066860d531e |
| institution | Kabale University |
| issn | 1590-9999 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SpringerOpen |
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| series | Journal of Orthopaedics and Traumatology |
| spelling | doaj-art-44002ac776f44868a01a4066860d531e2025-01-19T12:34:44ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99992025-01-0126111110.1186/s10195-025-00817-2Ipsilateral concomitant fractures of the clavicle and coracoid process of the scapula: incidence, characteristics, and outcomesNan Zhang0Guoyang Bai1Xiaomin Kang2Yangjun Zhu3Dongxu Feng4Department of Pathology, Hong Hui Hospital, Xi’an Jiaotong University School of MedicineShaanxi University of Chinese MedicineCenter for Translational Medicine, the First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Orthopaedic Trauma, Hong Hui Hospital, Xi’an Jiaotong University School of MedicineDepartment of Orthopaedic Trauma, Hong Hui Hospital, Xi’an Jiaotong University School of MedicineAbstract Background Clavicle fractures associated with ipsilateral coracoid process fractures are very rare, with limited literature reporting only a few cases. This study reports on 27 patients with ipsilateral concomitant fractures of the clavicle and coracoid process who were followed for more than 12 months. Material and methods This retrospective study reviewed the charts of skeletally mature patients with traumatic ipsilateral clavicle and coracoid process fractures treated at the authors’ institution. Each patient was regularly followed post-treatment. Radiographs assessed bone union and implant integrity, while clinical evaluations included the Constant–Murley score for shoulder function; disability of the arm, shoulder, and hand (DASH) questionnaire for upper limb function; and visual analog scale score for pain. Complications were also recorded. Results From October 2012 to February 2023, 40 patients were diagnosed with ipsilateral fractures of the clavicle and coracoid process of the scapula, accounting for 1.4% (40/2877) of all clavicle fractures and 5.2% (40/786) of all scapular fractures. This study included 27 patients with follow-up exceeding 12 months: 6 had medial-third clavicle fractures, 12 had middle-third fractures, and 9 had distal-third fractures. According to Eyres’ classification, the coracoid fractures included two type I, five type II, eight type III, seven type IV, and five type V fractures. Twenty-two patients received operative treatment, with clavicle fractures fixed with internal plating and 11 coracoid fractures with internal fixation. Bone union was achieved in all patients. The mean Constant–Murley score was 91.2 ± 9.4 and the mean DASH score was 6.4 ± 7.6. Five patients reported mild shoulder pain and five patients developed complications. Conclusions Ipsilateral concomitant fractures of the clavicle and coracoid process can occur at various clavicle locations, with shaft and medial fractures more common than previously thought. Displaced fractures can be effectively managed with operative treatment, and coracoid process fixation may not be necessary if satisfactory indirect reduction is achieved after clavicle fixation. Level of evidence: Level III, retrospective cohort study.https://doi.org/10.1186/s10195-025-00817-2ClavicleCoracoid processFracturesOpen reduction and internal fixationSuperior shoulder suspensory complex |
| spellingShingle | Nan Zhang Guoyang Bai Xiaomin Kang Yangjun Zhu Dongxu Feng Ipsilateral concomitant fractures of the clavicle and coracoid process of the scapula: incidence, characteristics, and outcomes Journal of Orthopaedics and Traumatology Clavicle Coracoid process Fractures Open reduction and internal fixation Superior shoulder suspensory complex |
| title | Ipsilateral concomitant fractures of the clavicle and coracoid process of the scapula: incidence, characteristics, and outcomes |
| title_full | Ipsilateral concomitant fractures of the clavicle and coracoid process of the scapula: incidence, characteristics, and outcomes |
| title_fullStr | Ipsilateral concomitant fractures of the clavicle and coracoid process of the scapula: incidence, characteristics, and outcomes |
| title_full_unstemmed | Ipsilateral concomitant fractures of the clavicle and coracoid process of the scapula: incidence, characteristics, and outcomes |
| title_short | Ipsilateral concomitant fractures of the clavicle and coracoid process of the scapula: incidence, characteristics, and outcomes |
| title_sort | ipsilateral concomitant fractures of the clavicle and coracoid process of the scapula incidence characteristics and outcomes |
| topic | Clavicle Coracoid process Fractures Open reduction and internal fixation Superior shoulder suspensory complex |
| url | https://doi.org/10.1186/s10195-025-00817-2 |
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