Concomitant Coracoid Process Fracture and Massive Rotator Cuff Tear: A Rare Case Report and Surgical Management Approach

Coracoid process fractures are rare injuries that can be overlooked, especially when they occur in isolation or alongside soft tissue damage. This case report describes a unique clinical presentation involving a displaced coracoid process fracture with a concomitant massive rotator cuff tear following high-energy trauma. The diagnostic process required a multimodal imaging approach to accurately assess both bony and soft tissue structures, which was critical in formulating an effective treatment plan. Surgical management involved open reduction and internal fixation of the coracoid fracture through a deltopectoral approach, followed by a mini-open lateral approach for rotator cuff repair using suture anchors. Postoperative rehabilitation was structured in progressive phases to support tendon healing and functional recovery. The patient achieved full, pain-free range of motion and radiographic union by six months post-surgery. This case underscores the need for heightened clinical awareness when evaluating anterior shoulder trauma and demonstrates that a dual surgical approach, tailored to address both osseous and soft tissue injuries, can yield excellent outcomes. Reporting such rare cases contributes to the evolving understanding and management strategies for complex shoulder injuries involving the coracoid process and rotator cuff.