New System for the Classification of Epiphyseal Separation of the Coracoid Process: Evaluation of Nine Cases and Review of the Literature

Table 2

Characteristics of patients with epiphyseal separation of the coracoid process identified from the literature review.

	Location of separation	Publish year	Author	Age	Sex	Cause of injury	Mechanism of injury	Associated injury	Treatment	Functional outcome
1	Tip (III)	1971	Benton J	19	M	Tennis	Overuse or forceful resisted flexion of the arm	—	Conjoined tendon reattach	Excellent
2	Base (I)	1975	Protass JJ	17	M	Football	Unknown	AC dislocation (III)	Conservative	Unknown
3	Base (I)	1975	Protass JJ	14	M	Fall off the bicycle	Unknown	AC dislocation (II)	Conservative	Unknown
4	Center (II)	1977	Montgomery SP	15	M	Football	Fall on the shoulder	AC dislocation (III)	Epiphysis reattached by a nonabsorbable suture	Excellent
5	Center (II)	1977	Montgomery SP	15	M	Bike accident	Unknown	AC dislocation (III)	Conservative (sling 4 weeks)	Poor
6	Base (I)	1982	Bernard TN	13	M	Football	Direct trauma	AC dislocation (III)	Conservative (AC immobilizer 4 weeks)	Excellent
7	Base (I)	1982	Bernard TN	15	M	Football	Fall on the shoulder	AC dislocation (III)	Conservative (AC immobilizer 6 weeks)	Excellent
8	Base (I)	1982	Bernard TN	17	M	Motorcycle	Direct trauma	AC dislocation (III)	ACJ: K-wiring, coracoid: screw fixation	Good
9	Base (I)	1986	Taga I	9	F	Unknown	Unknown	—	Conservative (Velpeau bandage 4 weeks)	Excellent
10	Base (I)	1990	Martin-Herrero T	16	M	Free skating	Forceful resisted flexion of the arm	AC dislocation (III)	Conservative (Desault bandage 4 weeks)	Excellent
11	Base (I)	1990	Martin-Herrero T	17	M	Judo	Fall on the shoulder	AC dislocation (?)	Conservative (Watson–Jones bandage 3 weeks)	Excellent
12	Base (I)	1995	Combalia A	12	M	Soccer	Fall on the shoulder	AC dislocation (III)	Conservative (Robert–Jones bandage 4 weeks)	Excellent
13	Base (I)	1995	Eyres KS	17	M	Folk-lift overturn	Trapping the arm	AC dislocation (III)	Conservative (broad arm sling)	Unknown
14	Base (I)	1996	Cottalorda J	15	M	Judo	Fall on the shoulder	—	Conservative	Excellent
15	Base (I)	1998	Holst AK	13	M	Fall	Fall on the shoulder	—	Conservative (broad arm sling 2 weeks)	Excellent
16	Base (I)	1999	Naraen A	11	M	Archery	Overuse or forceful resisted flexion of the arm	—	Conservative (sling 2 weeks)	Excellent
17	Base (I)	2009	Dipaora M	15	M	American football	Direct trauma by tackle	AC dislocation (II)	Conservative (sling)	Excellent
18	Center (II)	2009	Leijnen M	16	M	Fall off motorcycle	Fall on the shoulder	—	Conservative	Excellent
19	Base (I)	2010	Jettoo P	12	M	Fall from high place	Fall on the shoulder	AC dislocation (III)	ACJ: K-wiring coracoid: screw fixation	Excellent
20	Tip (III)	2011	Nakama K	16	M	Gymnastic (frying ring)	Overuse or forceful resisted flexion of the arm	—	Coracoid: screw fixation	Excellent
21	Base (I)	2012	Alsey KJ	14	?	Rugby	Direct trauma by tackle	—	Conservative (sling 4 weeks)	Excellent
22	Base (I)	2012	Chitre AR	13	M	Ski	Fall on the shoulder	—	Conservative	Excellent
23	Base (I)	2012	Chitre AR	15	M	Wheelbarrow race	Fall on the shoulder	—	Conservative	Excellent
24	Base (I)	2014	Pedersen V	14	M	Ice-hockey	Direct trauma by tackle	AC dislocation (II)	Conservative (sling)	Excellent
25	Center (II)	2016	Ito T	15	F	Judo	Direct trauma	AC dislocation (III)	ACJ: K-wiring coracoid: soft anchor fixation	Excellent
26	Tip (III)	2016	Archik S	15	M	Cricket	Overuse or forceful resisted flexion of the arm	—	Coracoid: screw fixation	Excellent
27	Base (I)	2018	Cross GWV	15	M	Rugby tackled violently	Direct trauma by tackle	AC dislocation (III)	Conservative (sling)	Excellent
28	Base (I)	2019	Duerr RA	12	M	Scooter accident	Direct trauma to the superolateral shoulder	Epiphyseal separation of the distal clavicle, CCL tear (triple injury)	Coracoid: screw fixation CCL and ACL repair	Excellent

AC, acromioclavicular; ACJ, acromioclavicular joint; CCL, coracoclavicular ligament; F, female; M, male. The numbers in parentheses indicate the grade of AC dislocation (II: subluxation of AC joint; III: complete dislocation of AC joint; ?: unidentified).