Glenohumeral instability and coracoid fracture nonunion corrected without coracoid transfer or nonunion takedown.

Anterior shoulder dislocations are commonly associated with humeral greater tuberosity fractures (w16% of cases), which include Hill-Sachs lesions. The second most common fracture associated with an anterior shoulder dislocation is a fracture of the anterior glenoid (i.e., bony Bankart lesion). By comparison, a coracoid fracture occurring in association with an anterior shoulder dislocation is uncommon. In fact, fractures of the coracoid process are generally very uncommon, representing only 2% to 5% of all fractures of the scapula, including those not associated with a shoulder dislocation. Although symptomatic nonunion is a known complication of coracoid fractures, the majority of isolated coracoid fractures with minimal or no displacement heal with 6 weeks of immobilization without surgery. A very small number of anterior shoulder dislocations with coracoid fractures lead to chronic problems. This includes chronic glenohumeral instability with a coracoid fracture nonunion. We report a case of a shoulder injury that resulted in chronic glenohumeral instability and a basilar coracoid fracture nonunion. These problems were surgically corrected with a conventional open capsular shift and surgical fixation of the coracoid nonunion without takedown of the nonunion site or transfer of the coracoid. This is a unique case because in a majority of reported cases of the association of these 2 problems, the nonunion was mobilized and transferred to the region of the glenoid neck (i.e., Bristow-Latarjet procedure) or involved other perturbation of the subscapularis in the vicinity of the glenoid neck. Our patient was able to return to his work in heavy manual labor as an automobile mechanic and was very satisfied with his final result.