An Unusual Pattern of Acromioclavicular Joint Instability With Coracoid Base Fracture

Area of Science:

• Orthopedic Surgery
• Traumatology
• Sports Medicine

Background:

• Concurrent acromioclavicular (AC) joint dislocation and coracoid process fracture is a rare injury pattern.
• This double disruption of the superior shoulder suspensory complex (SSSC) leads to mechanical instability.
• Optimal management for this rare injury remains debated due to its infrequency.

Purpose of the Study:

• To present a case of concurrent AC joint dislocation and coracoid process fracture.
• To evaluate the efficacy of surgical management for this rare injury pattern.
• To highlight the importance of careful diagnostic assessment for overlooked coracoid fractures.

Main Methods:

• A 43-year-old male with snowboarding-related shoulder injury underwent surgical management.
• The treatment involved AC joint stabilization with a hook plate and screw osteosynthesis for the coracoid fracture.
• Postoperative care included functional bracing and a structured rehabilitation program.

Main Results:

• Radiographs confirmed maintained reduction and fracture healing at 6 and 12 weeks.
• The hook plate was removed 3.5 months postoperatively.
• Follow-up demonstrated a healed coracoid base, congruent AC joint, minimal pain, and good shoulder function.

Conclusions:

• Surgical fixation effectively restores the biomechanical integrity of the SSSC.
• Combined AC joint and coracoid fixation provides a stable construct for anatomical healing.
• This approach allows for early functional rehabilitation and excellent radiological and clinical outcomes.