Ipsilateral nonunions of the coracoid process and distal clavicle--a rare shoulder girdle fracture pattern

Coracoid fractures are uncommon injuries, in isolation or in association with other osseoligamentous injuries about the shoulder girdle. We report a case of successful operative management of symptomatic ipsilateral nonunions of a type I coracoid base fracture and a lateral one-third clavicular fracture, which developed following nonoperative treatment of this exceedingly rare injury pattern. Following open distal clavicle excision and reduction of the coracoclavicular interval with screw fixation, radiographic union and excellent clinical outcome were achieved. This rare and potentially troublesome injury pattern is discussed, and the literature regarding ipsilateral coracoid and osseoligamentous injuries about the shoulder is reviewed.