Analysis of the effectiveness of arthroscopic cannulated screw fixation for coracoid process fractures

To evaluate the effectiveness of minimally invasive arthroscopic treatment for coracoid process fractures.

This retrospective study analyzed 17 patients with coracoid process fractures treated between January 2020 and October 2025, comprising 8 patients managed with shoulder arthroscopy (Arthroscopy group) and 9 patients treated via open surgery (Open group). Preoperative baseline characteristics, including gender, age, body mass index(BMI),injury mechanism, injury type, Eyres classification, and concomitant rotator cuff injuries, showed no significant differences between groups (P>0.05). We recorded operative duration, intraoperative blood loss, postoperative hospitalization, screw placement accuracy, fracture healing time, and complications. Treatment outcomes were evaluated using Visual Analog Scale (VAS), Constant-Murley, and university of California at Los Angeles shoulder rating scale (UCLA) scores.

The arthroscopy group demonstrated significantly reduced intraoperative blood loss and shorter postoperative hospitalization compared to the open group (P<0.05). Both groups showed significant postoperative improvement in VAS, Constant-Murley, and UCLA scores relative to preoperative values (P < 0.05). The arthroscopy group achieved superior VAS scores at 3 days and 3 months postoperatively compared to the open group (P < 0.05). Furthermore, Constant-Murley and UCLA scores improved more substantially in the arthroscopy group at 3 and 6 months postoperatively (P < 0.05). However, no significant intergroup differences emerged in these scores at 12-month follow-up (P > 0.05). Screw placement accuracy was comparable between groups (P > 0.05), with excellent rates of 75% (6/8) in the arthroscopy group and 77.8% (7/9) in the open group. Operative time and fracture healing time showed no significant intergroup differences (P > 0.05). During the follow-up period ranging from 10 to 21 months (mean 15.5 months), no screw displacement or pull-out occurred. Arthroscopic procedures identified one crescent-shaped supraspinatus tear repaired with suture anchors, while two minor superficial supraspinatus tendon tears received debridement. Neither group experienced neurovascular injuries or infections.

Compared to traditional open surgery, arthroscopic minimally invasive treatment of coracoid process fractures achieves comparable accuracy in screw placement, operative duration, and fracture healing time. The arthroscopic approach, however, results in less intraoperative bleeding and a shorter postoperative hospital stay. It also leads to more pronounced improvements in postoperative pain and shoulder function. Furthermore, it enables the concurrent treatment of associated shoulder pathologies, such as rotator cuff injury, acromial impingement, or glenohumeral joint lesions.