| Objectives:To discuss the methods of surgical treatment for different types of coracoid fracture.Comparing and analysing the efficiency of those therapies,and provide a reference for the treatment of coracoid fractures.Methods and materials:A retrospective analysis was done for 15 cases of coracoid fracture from June 2010 to December 2016,who has been treated in our department.Including 11 of male cases and 4 of female cases,the age of them ranged from 28 to 51 with an average age of 37.The injuries were caused by 7 cases of traffic accident,3 cases offall down injury,2 cases of high falling injury,1 cases of blunt trauma and 2 of other cases,which including 6 cases of kinds of associated injuries.According to the Eyres classification,there were 2 cases of Type ?B,2 cases of Type ?A,1 case of Type ?A,7 cases of Type ?A,and 3 cases of Type ?B.Based on the Rockwood classification,10 cases with dislocated acromioclavicular joint had 2 cases of Type ?,2 cases of Type ?,5 cases of Type ?,and 1 cases of Type ?.According to the Craig classification,2 cases with clavicle fractures had 1 case of Type ? and 1 cases of Type?A,both of them had mild ipsilateral dislocation of acromioclavicular joint.Preoperatively,we firstly control the fatal injuries in cases of who had serious traumas.Surgery wasn't performed untill the vital signs were get controlled.X-Ray,CT scan and the three-dimensional reconstruction of scapula was commended for the assessment of fractures.10 cases of Type ?,1 case of Type ? and 2 cases of Type ?were treated with ORIF(open reduction and internal fixation),while 2 cases of Type? were treated conservatively.Stabilization of acromioclavicular joint dislocation was by K-wires in 2 cases and by hook plate fixation in 8 cases.Postoperatively,the patient's arm was protected in a sling and swathe bandage.Results were recorded by completion of the post-op scoring forms.Results:The clinical outcomes of the 15 cases were assessed and they had been followed up for a mean of 10(range from 6 to 13)months.All of them had been healed without common postoperative complications,like postoperative infection,adverse long-term healing,neurovascular compromise,delayed union,nonunion,malunion etc.The average time of healing fracture line was 10.8 weeks for surgically treated in 13 cases.Those conservatively treated were restored for a longer time,which cost average 11.0 weeks.The average time of fracture lines' disappearance in 15 cases was 10.8 weeks.The Herscovici scores at latest follow-up examination in all cases were range of 12 to 16 points(average 14.1).Conclusions:Fracture of coracoid is uncommon.They were mainly caused by High-energetic trauma,like traffic trauma and fall injury.The multiple fractures caused by these accidents should consider the possibility of being accompanied by coracoid fracture,which might be missed with the disturbance of multiple complicated injures.For avoiding missed diagnosis,the CT scan and the three-dimensional reconstruction of scapula was strongly commended.Surgery performed through the delto-pectoral approach was found efficient for the cases of Type V fractures.We found recovering the dislocated acromioclavicular joint firstly,make the reduction of coracoid fracture easily when the coracoclavicular ligament was intact.The ORIF for the coracoid fractures can lead to successful outcomes with effective relief of pain and symptoms. |
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