Low‑Energy Fall With High‑Impact Consequences: A Case Report and Biomechanical Literature Review of Ogawa Type I Coracoid Process Avulsion Fracture With Acromioclavicular Joint Dislocation

Coracoid process fractures are rare injuries, usually associated with high-energy trauma and disruption of the superior shoulder suspensory complex (SSSC). We report the case of a 36-year-old male who sustained an Ogawa type I coracoid avulsion fracture with concomitant acromioclavicular (AC) joint dislocation following a low-energy mechanical fall. Initial radiographs demonstrated AC joint displacement with an associated coracoid fragment, further characterised by computed tomography (CT) with three-dimensional reconstruction. Imaging confirmed a displaced basal fracture involving the coracoclavicular ligament origin, representing a biomechanically unstable double disruption of the SSSC. Operative management consisted of open reduction and internal fixation of the coracoid with a cannulated lag screw combined with AC joint stabilisation using a hook plate and supplementary suture fixation. This case highlights the importance of recognising occult instability in uncommon shoulder injuries, the role of advanced imaging in operative planning, and the need to restore both bony and ligamentous continuity to re-establish shoulder girdle stability.