Ogawa Kiyohisa, Inokuchi Wataru, Matsumura Noboru
Department of Orthopedic Surgery, Eiju General Hospital, Taito-ku, Tokyo, Japan.
Department of Orthopedic Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo, Japan.
Orthop J Sports Med. 2020 Dec 16;8(12):2325967120967914. doi: 10.1177/2325967120967914. eCollection 2020 Dec.
Physeal injuries of the coracoid process are rare but may be increasing because of increased participation of youth in year-round sports.
To analyze reported physeal and apophyseal injuries of the coracoid process.
Systematic review; Level of evidence, 4.
PubMed and Scopus were searched using the terms and . The inclusion criteria were English full-text articles describing coracoid fracture as well as articles that described patient characteristics and presented appropriate images. The exclusion criteria were descriptive cases without images as well as those lacking appropriate images. Citation tracking was conducted to find additional articles and full-text articles written in other languages. Articles were included if they reported physeal injury or judged to involve physeal injury based on the provided images.
Overall, 22 studies including 32 patients (29 males, 3 females) were identified. All but 2 patients were younger than 18 years of age, and 66% (21/32) had sustained injuries during or as a result of participation in sporting activities. The affected site was the physis at the base in 18 patients, an intra-articular fracture in the primary coracoid ossification center combined with the subcoracoid ossification center to form an intra-articular fracture in 5, the apophysis of the tip in 3, the apophysis of the angle in 5, and uncertain in 1. Eleven patients had concurrent acromioclavicular injuries. The injury was acute in 23 patients, chronic in 6, and traumatic nonunion in 3. Among 21 cases in which treatment methods and outcomes were described, 21% of the acute cases (4/19), and 2 of the 3 nonunions were surgically treated. Only 1 study used a widely accepted evaluation method. Follow-up periods ranged from 6 weeks to 2 years. Outcomes were generally excellent for nonoperative and operative treatment and without any serious complications.
Coracoid physeal injuries occurred most commonly in patients aged 13 to 15 years of age (71%) and were usually sustained during or as a result of sports activities (66%). The most common injury site was the physis at its base. The cause of these injuries is probably severe or repeated traction of the attached muscles and ligaments. The majority of these injuries can be successfully treated nonoperatively.
喙突的骨骺损伤较为罕见，但由于青少年全年参与体育运动的人数增加，此类损伤可能呈上升趋势。
分析已报道的喙突骨骺和骺突损伤情况。
系统评价；证据等级为4级。
使用相关术语在PubMed和Scopus数据库中进行检索。纳入标准为描述喙突骨折的英文全文文章，以及描述患者特征并提供合适图像的文章。排除标准为无图像的描述性病例以及缺乏合适图像的病例。通过文献追踪查找其他语言撰写的额外文章和全文文章。若文章报道了骨骺损伤或根据提供的图像判断涉及骨骺损伤，则纳入研究。
共识别出22项研究，包括32例患者（29例男性，3例女性）。除2例患者外，所有患者年龄均小于18岁，66%（21/32）的患者在参与体育活动期间或因参与体育活动而受伤。18例患者的损伤部位为喙突基部的骨骺，5例为原发性喙突骨化中心与喙突下骨化中心联合形成的关节内骨折，3例为喙突尖端的骺突，5例为喙突角的骺突，1例损伤部位不明确。11例患者同时合并肩锁关节损伤。23例患者损伤为急性，6例为慢性，3例为创伤性骨不连。在描述了治疗方法和结果的21例病例中，21%的急性病例（4/19）以及3例骨不连中的2例接受了手术治疗。仅有1项研究使用了广泛接受的评估方法。随访期从6周至2年不等。非手术和手术治疗的结果总体良好，且无任何严重并发症。
喙突骨骺损伤最常见于13至15岁的患者（71%），通常在体育活动期间或因体育活动而发生（66%）。最常见的损伤部位是喙突基部的骨骺。这些损伤的原因可能是附着肌肉和韧带的严重或反复牵拉。这些损伤中的大多数可以通过非手术治疗成功治愈。
