Ipsilateral Rockwood type IV acromioclavicular joint dislocation and midshaft clavicle fracture: a case report and review of the literature.

The combination of ipsilateral acromioclavicular joint dislocation and midshaft clavicle fracture is rare. In the last 30 years, only 29 cases have been reported in literature. We present a case of a 55-year-old woman with this combined injury pattern on the right side after a fall from a bicycle. She underwent open reduction and plate fixation of the clavicle fracture and repair of both the acromioclavicular ligaments and the coracoclavicular joint with semi-rigid surgical implants. Six months of follow-up showed satisfactory results with full range of motion. In addition, we provide an overview of the literature regarding this rare injury pattern with treatment options and functional outcomes.

Treatment of coracoid process fractures: a systematic review.

INTRODUCTION: The coracoid process is a small hook-shaped feature on the scapula and a key structure of the superior shoulder suspensory complex (SSSC). Fractures of the coracoid are rare. Therefore, no consensus exists regarding treatment of coracoid process fractures. Systematically review indications, outcomes and complications of traumatic coracoid process fractures in adults, and to provide a treatment algorithm. MATERIALS AND METHODS: A systematic review was performed to identify all relevant studies on the treatment of coracoid process fractures. The methodological quality of the studies was scored using the Methodological Index for Non-Randomized Studies (MINORS). RESULTS: Eight case series, with a total of 110 coracoid process fractures, were included. All studies were of moderate methodological quality. Of the fractures, 78% were Ogawa type I fractures, 13% Ogawa type II and 9% were unclassified. Conservative treatment showed good results in most Ogawa type II fractures and type I fractures without associated disruptions of the SSSC. Most Ogawa type I fractures with associated disruptions of the SSSC received surgical treatment showing good results. CONCLUSION: Based on moderate quality studies, surgical treatment may be considered in Ogawa type I fractures with multiple disruptions of the SSSC. A conservative treatment seems sufficient in other fracture types.