Fractures of the Coracoid Process: Evaluation, Management, and Outcomes

Fractures of the coracoid process are relatively rare, and current management guidelines remain unclear. Most coracoid fractures occur in conjunction with other shoulder injuries, including dislocations and fractures. Identifying coracoid fractures can be difficult because most fractures are nondisplaced and can be missed on radiographs or may be masked by other injuries. Management is largely guided by fracture location and displacement. Conservative treatment is preferred for fractures that are minimally displaced, whereas indications for surgical fixation include fractures that are displaced (>1 cm), have progressed to a painful nonunion, or are associated with the disruption of the superior shoulder suspensory complex. Although conservative treatment has been historically favored, satisfactory outcomes have been reported for both surgical and nonsurgical treatment. We provide a comprehensive review of diagnosis and management strategies for coracoid fractures.