{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:53:58Z","timestamp":1768956838930,"version":"3.49.0"},"reference-count":31,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"research fund of Hanyang University","award":["HY- 202100000001140"],"award-info":[{"award-number":["HY- 202100000001140"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Coracoid process (CP) fractures combined with acromioclavicular (AC) joint dislocation are extremely rare, and evidence guiding optimal surgical management remains limited. This retrospective, single-center case series study evaluated clinical and radiologic outcomes after simultaneous fixation of both lesions using a clavicular hook plate and a coracoid screw. Materials and Methods: We retrospectively reviewed 15 consecutive patients with Ogawa type I CP fractures combined with AC joint dislocation who underwent clavicular hook plate and coracoid screw fixation between March 2019 and May 2024. Clinical outcomes at final follow-up included shoulder range of motion (ROM), visual analog scale (VAS) for pain, and the Constant score. Radiologic outcomes included CP union confirmed by computed tomography (CT) and residual AC joint subluxation. Results: The cohort comprised 13 men and 2 women with a mean age of 55.2 years, and the mean final follow-up was 40.2 months. At final follow-up, mean ROM was 168\u00b0 for forward elevation, 161\u00b0 for abduction, and 69\u00b0 for external rotation at the side, with internal rotation to L1. The mean VAS score was 0.4 and the mean Constant score was 97. CT-confirmed union of the CP fracture was achieved in all patients, and no residual AC joint subluxation was observed. All patients returned to sports and activities of daily living. Conclusions: In this series, simultaneous fixation using a clavicular hook plate and a coracoid screw provided reliable stabilization for CP fractures with AC joint dislocation, achieving consistent CP union, restoration of AC joint alignment, and favorable clinical outcomes. However, given the retrospective, non-comparative study design, these findings should be interpreted with caution, and further comparative studies are warranted.<\/jats:p>","DOI":"10.3390\/medicina62010212","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T11:27:58Z","timestamp":1768908478000},"page":"212","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Clavicular Hook Plate and Coracoid Screw Fixation for Coracoid Process Fractures Associated with Acromioclavicular Joint Dislocation"],"prefix":"10.3390","volume":"62","author":[{"given":"Bong Gun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Hanyang University College of Medicine, 222 Wangsimni-ro, Seoul 04763, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0217-2661","authenticated-orcid":false,"given":"Young Seok","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hanyang University Guri Hospital, 153 Gyeongchun-ro, Guri-si 11923, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang-Hun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hanyang University College of Medicine, 222 Wangsimni-ro, Seoul 04763, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2164-6965","authenticated-orcid":false,"given":"Wan-Sun","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Ajou University School of Medicine, 164 World Cup-ro, Suwon 16499, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang-Woo","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hanyang University Guri Hospital, 153 Gyeongchun-ro, Guri-si 11923, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4299-2496","authenticated-orcid":false,"given":"Young-Hoon","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hanyang University Guri Hospital, 153 Gyeongchun-ro, Guri-si 11923, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"ref_1","first-page":"171","article-title":"Fractures of the coracoid process: A systematic review","volume":"1","author":"Ogawa","year":"2021","journal-title":"JSES Rev. Rep. Tech."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1302\/0301-620X.79B1.0790017","article-title":"Fractures of the coracoid process","volume":"79","author":"Ogawa","year":"1997","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1007\/s00264-025-06435-1","article-title":"Acromioclavicular dislocation associated with fracture of the coracoid process: A series of cases and review of the literature","volume":"49","author":"Combalia","year":"2025","journal-title":"Int. Orthop."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1097\/00005131-199304000-00001","article-title":"Double disruptions of the superior shoulder suspensory complex","volume":"7","author":"Goss","year":"1993","journal-title":"J. Orthop. Trauma"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1007\/s00402-020-03496-2","article-title":"Treatment of coracoid process fractures: A systematic review","volume":"141","author":"Alta","year":"2021","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"706","DOI":"10.5435\/JAAOS-D-19-00148","article-title":"Fractures of the Coracoid Process: Evaluation, Management, and Outcomes","volume":"28","author":"Galvin","year":"2020","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jseint.2022.12.014","article-title":"Treatment of acromioclavicular dislocations with a concomitant coracoid fracture: A systematic review of 37 patients","volume":"7","author":"Broekman","year":"2023","journal-title":"JSES Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e548","DOI":"10.1016\/j.jse.2023.04.025","article-title":"Treatment of coracoid process fractures combined with acromioclavicular joint dislocation using clavicular hook plate","volume":"32","author":"Ye","year":"2023","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.jseint.2020.02.007","article-title":"Acromioclavicular joint dislocation associated with a coracoid process fracture: Report of 2 cases","volume":"4","author":"Lopiz","year":"2020","journal-title":"JSES Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e19.00637","DOI":"10.2106\/JBJS.CC.19.00637","article-title":"Subacute Acromioclavicular Dislocation After Basal Coracoid Process Fracture: Indirect Reduction without Open Reduction and Internal Fixation: A Case Report","volume":"10","author":"Arismendi","year":"2020","journal-title":"JBJS Case Connect."},{"key":"ref_11","first-page":"858969","article-title":"Acromioclavicular Dislocation Associated with Coracoid Process Fracture: Report of Two Cases and Review of the Literature","volume":"2015","author":"Kose","year":"2015","journal-title":"Case Rep. Orthop."},{"key":"ref_12","first-page":"403","article-title":"Displaced fracture of the coracoid process associated with acromioclavicular dislocation: A two-bird-one-stone solution","volume":"67","author":"Kim","year":"2009","journal-title":"J. Trauma"},{"key":"ref_13","first-page":"1","article-title":"Surgical management of multiple superior shoulder suspensory complex disruptions involving at least a coracoid fracture and an acromioclavicular dislocation: A report of five cases","volume":"11","author":"Tuor","year":"2023","journal-title":"SAGE Open Med. Case Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e22","DOI":"10.1016\/j.jse.2009.09.004","article-title":"Treatment of coracoid process fractures associated with acromioclavicular dislocation using clavicular hook plate and coracoid screws","volume":"19","author":"Duan","year":"2010","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e22324","DOI":"10.1097\/MD.0000000000022324","article-title":"Fractured coracoid process with acromioclavicular joint dislocation: A case report","volume":"99","author":"Zhang","year":"2020","journal-title":"Medicine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s13018-021-02203-0","article-title":"A guideline for screw fixation of coracoid process base fracture by 3D simulation","volume":"16","author":"Sun","year":"2021","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1302\/0301-620X.77B3.7744929","article-title":"Fractures of the coracoid process","volume":"77","author":"Eyres","year":"1995","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1097\/00005373-199012000-00031","article-title":"Fractures of the coracoid process: Presentation of seven cases and review of the literature","volume":"30","year":"1990","journal-title":"J. Trauma"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1302\/0301-620X.88B11.17997","article-title":"The floating shoulder","volume":"88","author":"Owens","year":"2006","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_20","first-page":"39","article-title":"Triple Disruption of the Superior Shoulder Suspensory Complex\u2014A Case Report","volume":"9","author":"Badam","year":"2019","journal-title":"J. Orthop. Case Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1007\/s00402-020-03657-3","article-title":"Nonunion of the coracoid process: A systematic review","volume":"141","author":"Ogawa","year":"2021","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e943108","DOI":"10.12659\/AJCR.943108","article-title":"Symptomatic Nonunion of the Coracoid Process Following Osteosynthesis Using a Suture Button for Coracoid Process and Distal Clavicle Fracture: A Case Report","volume":"25","author":"Furuhata","year":"2024","journal-title":"Am. J. Case Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"24","DOI":"10.4103\/eoj.eoj_157_23","article-title":"Dual fixation for coracoid fracture with acute acromioclavicular joint disruption: A case series","volume":"59","author":"Elshahhat","year":"2024","journal-title":"Egypt. Orthop. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"57","DOI":"10.5397\/cise.2018.21.2.57","article-title":"Are Hook Plate Complications Inevitable?","volume":"21","author":"Song","year":"2018","journal-title":"Clin. Shoulder Elb."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e1767","DOI":"10.1016\/j.eats.2020.07.019","article-title":"Arthroscopic Management of a Coracoid Fracture Associated with Acromioclavicular Dislocation: Technical Note","volume":"9","author":"Passaplan","year":"2020","journal-title":"Arthrosc. Tech."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.surneu.2004.03.024","article-title":"Intraoperative positioning nerve injuries","volume":"63","author":"Winfree","year":"2005","journal-title":"Surg. Neurol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/S0733-8619(05)70367-4","article-title":"Iatrogenic nerve injuries","volume":"16","author":"Wilbourn","year":"1998","journal-title":"Neurol. Clin."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Lee, S.J., Eom, T.W., and Hyun, Y.S. (2022). Complications and Frequency of Surgical Treatment with AO-Type Hook Plate in Shoulder Trauma: A Retrospective Study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11041026"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Oh, H.S., Kim, S., Hyun, J.H., and Kim, M.S. (2022). Effect of subacromial erosion shape on rotator cuff and clinical outcomes after hook plate fixation in type 5 acromioclavicular joint dislocations: A retrospective cohort study. BMC Musculoskelet. Disord., 23.","DOI":"10.1186\/s12891-021-04987-y"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"202","DOI":"10.5397\/cise.2021.00423","article-title":"Clinical outcomes of bending versus non-bending of the plate hook in acromioclavicular joint dislocation","volume":"24","author":"Joo","year":"2021","journal-title":"Clin. Shoulder Elb."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2070","DOI":"10.1007\/s00167-020-06036-y","article-title":"Shoulder outcome scoring systems have substantial ceiling effects 2 years after arthroscopic rotator cuff repair","volume":"29","author":"Jo","year":"2021","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/1\/212\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T12:06:49Z","timestamp":1768910809000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/1\/212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,20]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["medicina62010212"],"URL":"https:\/\/doi.org\/10.3390\/medicina62010212","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,20]]}}}