OBJECTIVE: Through three-dimensional finite element analysis,the biomechanical properties of five screw-based internal fixation schemes for coracoid process base fractures were compared.The differences among various schemes in terms of fracture end stability and stress distribution of the fixation screws were clarified,providing a scientific basis for the clinical precise selection of appropriate internal fixation methods. METHODS: A three-dimensional finite element model was constructed based on CT data. The model simulated the load on the coracoid process caused by mild traction (50N) and severe traction (250N) of the conjoined tendon and pectoralis minor. Five fixation schemes were simulated: single hollow screw with full intrabone fixation (M1), single hollow screw with partial cut-out below the vertical part of the coracoid process (M2), single hollow screw with partial cut-out above the vertical part of the coracoid process and fixation to the scapular spine (M3), dual hollow screws with full intrabone fixation (M4), and M5 (M1 + M3). The displacement of the fracture ends and the von Mises stress distribution of the fixation screws were analyzed for each scheme. RESULTS: The dual hollow screw fixation schemes (M4 and M5) showed optimal performance under both 50N and 250N loads, with significantly lower displacement of the coracoid process and von Mises stress on the screws compared to other schemes. The single conventional screw (M2) had the highest displacement and stress values due to stress concentration at the root of the screw, indicating a higher risk of postoperative loosening. Overall, dual screw fixation was superior to single screw fixation. CONCLUSION: The three-dimensional finite element analysis shows that double hollow screw fixation for the fractures of the coracoid process base provides a better effect and offers the optimal biomechanical stability, while a single screw is suitable for simple fractures. Single hollow screw with partial cut-out above the vertical part of the coracoid process can also achieve good results, but it is necessary to avoid partial cut-out below the vertical part of the coracoid process.