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Case Reports in Orthopedics
Volume 2016 (2016), Article ID 1836070, 5 pages
http://dx.doi.org/10.1155/2016/1836070
Case Report

Avulsion Fracture of the Coracoid Process at the Coracoclavicular Ligament Insertion: A Report of Three Cases

1Department of Orthopedic Surgery, Eiju General Hospital, 2-23-16 Higashi-Ueno, Taito-ku, Tokyo 110-8645, Japan
2Department of Orthopedic Surgery, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan

Received 8 August 2016; Accepted 3 November 2016

Academic Editor: Pedro Carpintero

Copyright © 2016 Takeshi Morioka et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Avulsion fracture at the site of attachment of the coracoid process of the coracoclavicular ligament (CCL) is extremely rare. We presented three adult cases of this unusual avulsion fracture associated with other injuries. Case  1 was a 25-year-old right-handed male with a left distal clavicular fracture with an avulsion fracture of the coracoid attachment of the CCL; this case was treated surgically and achieved an excellent outcome. Case  2 was a 39-year-old right-handed male with dislocation of the left acromioclavicular joint with two avulsion fractures: one at the posteromedial surface of the coracoid process at the attachment of the conoid ligament and one at the inferior surface of the clavicle at the attachment site of the trapezoid ligament; this case was treated conservatively, and unfavorable symptoms such as dull pain at rest and sharp pain during some daily activities remained. Case  3 was a 41-year-old right-handed female with a right distal clavicular fracture with an avulsion fracture of the coracoid attachment of the conoid ligament; this case was treated conservatively, and the distal clavicular fracture became typical nonunion. These three cases corresponded to type I fractures according to Ogawa’s classification as the firm scapuloclavicular connection was destroyed and also to double disruption of the superior shoulder suspensory complex. We recommend surgical intervention when treating patients with this type of acute or subacute injury, especially in those engaging in heavy lifting or overhead work.