synonyms:coracoid process fracture, conjoined tendon origin fracture
Coracoid Process Fracture ICD-10
- S42.131A - Displaced fracture of coracoid process, right shoulder, initial encounter for closed fracture
- S42.132A - Displaced fracture of coracoid process, left shoulder, initial encounter for closed fracture
- S42.133A - Displaced fracture of coracoid process, unspecified shoulder. initial encounter for closed fracture
- S42.134A - Nondisplaced fracture of coracoid process, right shoulder, initial encounter for closed fracture
- S42.135A - Nondisplaced fracture of coracoid process, left shoulder, initial encounter for closed fracture
- S42.136A - Nondisplaced fracture of coracoid process, unspecified shoulder, initial encounter for closed fracture
- See All Coracoid Process ICD-10.
- A - initial encounter for closed fracture
- B - initial encounter for open fracture
- D - subsequent encounter for fracture with routine healing
- G - subsequent encounter for fracture with delayed healing
- K - subsequent encounter for fracture with nonunion
- P - subsequent encounter for fracture with malunion
- S - sequela
Coracoid Process Fracture ICD-9
- 811.02 Fracture of scapula; closed, coracoid process
- 811.12 Fracture of scapula; open, coracoid process
Coracoid Process Fracture Etiology / Epidemiology / Natural History
- Uncommon. 3%-13% of all scapular fractures. <1% of all fractures.
- Generally associated with acromial, clavicular, or scapular fracture, acromioclavicular separation or glenohumeral dislocation.
Coracoid Process Fracture Anatomy
- Short head of the biceps, coracobrachialis and pectoralis minor attached to the coracoid process.
Coracoid Process Fracture Clinical Evaluation
- Tenderness and swelling in the anterior shoulder.
- Pain with abduction and external rotation.
- Document neurovascular examination. May cause compression on the brachial plexus and suprascapular nerve.
Coracoid Process Fracture Xray / Diagnositc Tests
- Shoulder xray demonstrates displacement of coracoid process. May be difficult to see on plain films
- MRI demonstrates osseous avulsion of the coracoid process and can be used to determine which muscles are attached to the displaced fragment.
- CT: best deliniates fracture configuration.
- Consider EMG prior to surgery.
Coracoid Process Fracture Classification / Treatment
- Nondisplaced: Conservative care with sling and activity limitations.
- Displaced: treatment is controversial. Consider ORIF generally through an anterior approach with fixation with 3.5mm screw and washer.
Coracoid Process Fracture Associated Injuries / Differential Diagnosis
Coracoid Process Fracture Complications
- Delayed union / nonunion
- Hardware failure
- Incisional scar (cosmesis)
- Shoulder pain
- Shoulder stiffness
Coracoid Process Fracture Follow-up Care
- Post-op: sling for comfort, no overhead motion. Immediate pendelum ROM exercises.
- 10-14 Days: Wound check, sutures removed. Start PT for gentle ROM exercises. No resistive exercises/activities. Sling as needed for comfort.
- 6 weeks: Xrays, if union is evident begin strengthening and resistive exercises. No contant athletics.
- 3 months: Repeat xrays. If pt is painfree and union is obvious pt may return to sport. Generally avoid contact sports and heaving lifting for 4-6 months.
- Shoulder Outcome measures.
Coracoid Process Fracture Review References
- Hill BW, Jacobson AR, Anavian J et-al. Surgical management of coracoid fractures: technical tricks and clinical experience. J Orthop Trauma. 2014;28 (5): e114-22.
- Petty OH. “Fracture of the coracoid process of the scapula caused bymuscular action,” Annals of Surgery. 1907;45(3):427–430. Ogawa K, Yoshida A, Takahashi M, and Ui M, “Fractures of the coracoid process.”. Journal of Bone and Joint Surgery B, 1997; 79, (1):17-19.
- McGinnis M, Denton JR. “Fractures of the Scapula: A Retrospective Study of 40 Fractured Scapulae. Journal of Trauma and Acute Care Surgery. 1989;29(11):1488–1493.
- Eyres KS, Brooks A, Stanley D. “Fractures of the Coracoid Process.” The Journal of Bone and Joint Surgery. 1995;77(3):425–428.
- Ada JR, Miller ME. “Scapular fractures: analysis of 113 cases.” Clinical Orthopaedics and Related Research. 1991;269:174–180.