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Orthogonal Biplanar Fluoroscopy-guided Percutaneous Fixation of a Coracoid Base Fracture Associated With Acromioclavicular Joint Dislocation

Bhatia, Deepak N. MS (Orth), DNB (Orth)

Techniques in Hand & Upper Extremity Surgery:
doi: 10.1097/BTH.0b013e31823e2172
Techniques
Abstract

Coracoid process fractures that involve the coracoid base (inferior pillar) without a concomitant rupture of the coracoclavicular ligaments can destabilize the acromioclavicular joint with its subsequent dislocation; prophylactic or therapeutic operative treatment involving open reduction and internal fixation has been traditionally recommended. This report presents a new technique of percutaneous reduction and stabilization of the coracoid fracture with indirect acromioclavicular joint reduction under fluoroscopic guidance; biplanar visualization of coracoid process anatomy is obtained using 2 specific radiographic/fluoroscopic-beam angulations (Bhatia views), and this permits a guided placement of screws for controlled reduction of this dual injury. The technique is based on the author’s original work on coracoid process anatomy and development of radiographic views for orthogonal visualization of coracoid pillars in their entirety. Technical tips to facilitate percutaneous fracture fixation and to avoid potential complications are discussed.

Author Information

Department of Orthopaedic Surgery, Seth GS Medical College and King Edward VII Memorial Hospital, Mumbai, India

No funding has been received from National Institutes of Health (NIH), Wellcome Trust, and Howard Hughes Medical Institute (HHMI).

Conflicts of Interest and Source of Funding: The author reports no conflicts of interest and no source of funding.

Address correspondence and reprint requests to Deepak N. Bhatia, MS (Orth), DNB (Orth), Department of Orthopaedic Surgery, Seth GS Medical College and King Edward VII Memorial Hospital, Parel, Mumbai 400012, India. E-mail: thebonesmith@gmail.com.

© 2012 Lippincott Williams & Wilkins, Inc.