Os acromiale, a cause of shoulder pain, not to be overlooked

Barbier, Olivier; Block, Damien; Dezaly, C.; Sirveaux, François; Molé, Daniel

doi:10.1016/j.otsr.2012.10.020

Cited by 31 publications

(32 citation statements)

References 23 publications

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“…As to the unstable and painful os acromiale, internal fixation can fix the fragment and relieve the pain from the pulling of deltoid; therefore, its primacy and significance are widely recognized. Fusion is sometimes difficult to accomplish, so some surgeons prefer to use a transacromial approach to preserve the terminal branches of the thoracoacromial artery (Fig.…”

Section: Methods Of Searchingmentioning

confidence: 99%

“…Fusion is sometimes difficult to accomplish, so some surgeons prefer to use a transacromial approach to preserve the terminal branches of the thoracoacromial artery (Fig. ); furthermore, some doctors tend to use local bone graft or iliac crest bone graft to improve the fusion. During the operation, there are two key points which need to be considered.…”

Section: Methods Of Searchingmentioning

confidence: 99%

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Os Acromiale: Reviews and Current Perspectives

You

Frostick

Zhang

et al. 2019

Orthopaedic Surgery

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Os acromiale is a developmental defect which results from the lack of an osseous union between the ossification centers of the acromion, leading to the fibrocartilaginous tissue connection. The prevalence of os acromiale is 1% to 15%, and is quite common in the African American population. Os acromiale in adults is easily diagnosed by symptoms and X‐ray, particularly on the axillary view; however, the differential diagnosis of adolescents may require MRI or SPECT–CT. Generally, nonoperative therapy for symptomatic os acromiale should be started, including physiotherapy, nonsteroidal anti‐inflammatory drugs, and injections. Surgical treatment is indicated after failed conservative treatment. In symptomatic patients with fixable acromiale, the tension band technique should be used to make the anterior aspect of the acromion elevated from the humerus head. In patients with small fragments which are unsuitable for reattachment, excision might be the best therapeutic option and lead to good outcomes. Whether using internal fixation or resection, the arthroscopic technique results in a better outcome and fewer complications, especially in older patients or athletes with overhead movement, because of the high incidence of shoulder impingement or rotator cuff tears which can be treated concurrently.

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Section: Methods Of Searchingmentioning

confidence: 99%

Section: Methods Of Searchingmentioning

confidence: 99%

Os Acromiale: Reviews and Current Perspectives

You

Frostick

Zhang

et al. 2019

Orthopaedic Surgery

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“…This diagnostic tool is useful to determine if the meso-acromiale is the source of the pain. 10 If the lidocaine injection does help relieve or reduce pain, it is not unreasonable to then administer a one-time corticosteroid injection into the same region for therapeutic purposes, which may give symptomatic long-term pain relief in some patients. Table 1 lists the pearls and pitfalls of diagnosing a symptomatic meso-acromion.…”

Section: Preoperative Diagnosis and Imagingmentioning

confidence: 99%

“…When nonoperative management fails, surgery is the next treatment option for a symptomatic mesoacromion. A number of surgical techniques have been described such as open fragment excision, arthroscopic acromioplasty, 1,5,11,12 open reductioneinternal fixation (ORIF) with cannulated screws or tension band wiring, [3][4][5][6]10,13,14 ORIF with cannulated screws combined with Kirschner wires used in tension band wiring, 14 and arthroscopic resection of the unstable fragment. 5,[15][16][17] ORIF with iliac crest bone graft has also been described with favorable results.…”

Section: Surgical Optionsmentioning

confidence: 99%

“…5,[15][16][17] ORIF with iliac crest bone graft has also been described with favorable results. 5,10,15,16 ORIF is the most common surgical procedure and can lead to radiographic healing in a vast majority of patients. 5,10 Biomechanical studies have shown that cannulated screws with Kirschner wires in a tension band configuration lead to significantly higher repair strength at time zero in a cadaveric model when compared with cannulated screws alone.…”

Section: Surgical Optionsmentioning

confidence: 99%

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Arthroscopic Excision of a Symptomatic Meso-acromiale

Stetson

McIntyre

Mazza

2017

Arthroscopy Techniques

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The surgical technique for the management of a symptomatic os acromiale remains unclear. Several operative techniques have been described including open excision, open reduction-internal fixation (ORIF), arthroscopic acromioplasty or subacromial decompression, and arthroscopic excision. There are 4 types of os acromiale, with the meso-acromion being the most common and difficult to treat. The excision of a pre-acromion arthroscopically or in an open manner usually produces satisfactory results. However, the open excision of a meso-acromion can lead to persistent pain and deltoid weakness and atrophy. The management of a meso-acromial fragment with ORIF can also result in persistent pain and deltoid weakness and atrophy with nonunion of the fragments. The purpose of this article is to describe an alternative surgical technique to open excision or ORIF when presented with a symptomatic meso-acromiale.

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