Safety screw fixation technique in a case of coracoid base fracture with acromioclavicular dislocation and coracoid base cross-sectional size data from a computed axial tomography study

• Published in: Archives of orthopaedic and trauma surgery Vol. 134; no. 7; pp. 913 - 918
• Main Authors: Kawasaki, Yoshiteru, Hirano, Tetsuya, Miyatake, Katsutoshi, Fujii, Koji, Takeda, Yoshitsugu
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2014; Springer Nature B.V
• Subjects: Acromioclavicular Joint - diagnostic imaging; Acromioclavicular Joint - injuries; Adolescent; Adult; Aged; Bone Screws; Cross-Sectional Studies; Female; Fracture Fixation, Internal - instrumentation; Fracture Fixation, Internal - methods; Fractures, Bone - diagnostic imaging; Fractures, Bone - surgery; Humans; Ligaments, Articular - diagnostic imaging; Ligaments, Articular - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Occupational accidents; Orthopaedic Surgery; Orthopedics; Scapula - diagnostic imaging; Scapula - injuries; Shoulder Dislocation - diagnostic imaging; Shoulder Dislocation - surgery; Tomography; Tomography, X-Ray Computed - methods; Screw fixation; Acromioclavicular joint dislocation; Fracture of the coracoid base
• ISSN: 0936-8051; 1434-3916; 1434-3916
• DOI: 10.1007/s00402-014-1995-7

Coracoid base fracture accompanied by acromioclavicular joint dislocation with intact coracoclavicular ligaments is a rare injury. Generally, an open reduction with screw fixation is the first treatment choice, as it protects the important structures around the coracoid process. This report presents a new technique of screw fixation for coracoid base fracture and provides anatomic information on cross-sectional size of the coracoid base obtained by computed tomography (CT). An axial image of the coracoid base was visualized over the neck of the scapula, and a guidewire was inserted into this circle under fluoroscopic guidance. The wire was inserted easily into the neck of scapula across the coracoid base fracture with imaging in only 1 plane. In addition, 25 measurements of the coracoid base were made in 25 subjects on axial CT images. Average length of the long and short axes at the thinnest part of the coracoid base was 13.9 ± 2.0 mm (range 10.6–17.0) and 10.5 ± 2.2 mm (6.6–15.1), respectively. This new screw fixation technique and measurement data on the coracoid base may be beneficial for safety screw fixation of coracoid base fracture.