Clinical outcomes of coracoid fractures

The coracoid process, also known as the lighthouse of the shoulder, is a
hook-like structure that is part of the scapula. It has three basic functions:
- Serving as a point of attachment for multiple musculotendinous and
ligamentous structures
- Providing the glenohumeral joint with anterosuperior stability
- Serving as an integral part of the SSSC (Superior shoulder suspensory
complex)
Coracoid fractures are rare whereas the incidence has been assessed between 3%
and 13% of all scapular fractures. These constitute 1% of all fractures.

According to Ogawa et al. coracoid fractures can be classified in to two types
depending on the location of the fracture. Type I fractures are located
posterior from the trapezoid and conacoid ligament. Type II fractures are
located on the anterior side of both ligaments. Retrospective study shows that
87% of all conservative treated type II fractures have a good outcome in
function and pain.
The SSSC is an imaginary bony/soft tissue ring that is composed of the glenoid
process, coracoid process, coracoclavicular ligaments, distal clavicle, AC
joint and the acromial process. Commonly associated injuries are
acromioclavicular dislocations, glenoid rim fractures, clavicular fractures and
acromial fractures and even scapula fractures.
Type I fractures are often associated with ipsilateral injury to SSSC.
According to Goss there is an increased chance of developing chronic complaints
after conservative treatment if there is a double disruption of the SSSC. Oh et
al. also reported that an operative treatment gives a better outcome when there
were two or more disruptions of the SSSC.

Currently there is little scientific data about the clinical outcomes of the
conservative and operative treatment of coracoid fractures. Most of the studies
performed are case reports or retrospective studies with a small population.
Therefore, we want to perform a follow-up study on the clinical outcomes of all
the patients with a coracoid fracture who were treated in het Spaarne Gasthuis
and Bergman Clinics.

The researcher will search the database for patients who were treated for a
coracoid fracture in the Spaarne Gasthuis Hoofddorp and Bergman Clinics in
Naarden. The patients will receive a request letter through mail about the
study. After one week the researcher will contact the patient by telephone to
determine whether he/she wants to participate. If the patient is willing to
participate an appointment will be scheduled to give informed consent.
Additionally, the questionnaires will be filled in, the physical examination
will be performed and an x-ray of the shoulder will take place.

During the appointment an x-ray of the shoulder will be made. The total
radiation exposure in this study is 0.001 mSv. This exposure has a minimal risk
of health damage