Postoperative results of Ogawa type IIB meta-acromion fracture fixation with a 90° twisted reconstruction plate

Konstantinidis, George; Smithers, Troy; Hong, Thin

doi:10.1007/s00402-020-03351-4

Cited by 6 publications

(14 citation statements)

References 27 publications

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“…Owage [13] recommends that patients with type I acromial fractures be treated with Kirschner wire or tension band xation. However, there are reports of Kirschner wires loosening, fracture redisplacement, and needle tract infection after using this xation method [4,11,12 ]. We also do not recommend for the use of Kirschner wires because they does not provide adequate compression at the fracture site.…”

Section: Discussionmentioning

confidence: 92%

“…The usual xation methods include Kirschner wires, tension band and anatomical locking plates [3,9,13].However, in the type I fracture ,conventional plate xation is not recommended because of the very thin and small nature of the osseous anatomy. Fixation with Kirschner wire cannot pressurize the fracture end and is prone to early xation failure [4,12] At present, in the treatment of distal acromial fractures, two cannulated screws instead of Kirschner wire xation is considered to be an effective method which had high postoperative fracture healing rate and no complications [5][6][7][8]. Peckett et al reported that 17 patients with symptomatic acromial fractures were xed with two 3.5mm screws and the postoperative healing rate was 94% [6].…”

Section: Introductionmentioning

confidence: 99%

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The Study of Screw Placement Parameters for Ogawa Type I Acromial Fractures by 3D Technology

Zhang

Sun

et al. 2021

Preprint

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Background: Acromial fractures are rare and there is no consensus on fixation, but more and more studies have reported using two screws to fix Ogawa type I acromial fractures. The objective of this study was to obtain the ideal length, diameter, insertion point and angle of the screw using a novel 3D technology. Methods: Scapula CT data of 100 human subjects were obtained to reconstruct 3D models. The transparency of 3D models was then downgraded along the axial perspective (the view perpendicular to the cross section of the acromial axial) to find the maximum translucent area. Two virtual screws were placed from the anterior edge of the acromial until they penetrated the posterior cortical bone. The largest diameters and lengths of the screw were measured, and the direction and insertion point of the screw were observed.Results: The mean maximum lengths of medial and lateral screws were 43.33±6.17mm and 39.23±6.01mm, respectively. The mean maximum diameters of medial and lateral screws were 4.71±1.23 mm and4.97±1.07mm, respectively. The study found differences in screw length, diameter and insertion point between males and females. The differences sexes in screw angle were not statistical significance.Conclusions: Using the 3D model, we demonstrated that the distal acromial can be safely placed with two screws and provide valuable guidance for screw fixation of Ogawa type I acromial fractures.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The Study of Screw Placement Parameters for Ogawa Type I Acromial Fractures by 3D Technology

Zhang

Sun

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Owage [ 3 ] recommends that patients with type I acromial fractures be treated with Kirschner wire or tension band fixation. However, there are reports of Kirschner wire loosening, fracture redisplacement, and needle tract infection after the use of this fixation method [ 6 , 7 , 22 ]. We also do not recommend the use of Kirschner wires because they do not provide adequate compression at the fracture site.…”

Section: Discussionmentioning

confidence: 99%

“…Screw fixation has been gradually recognized for its ability to provide adequate fracture compression and offer satisfactory fracture stability [ 7 – 11 , 20 ]. Peckett et al [ 9 ] recommended the use of double tension screws instead of Kirschner wires in 26 patients with acromial fractures.…”

Section: Discussionmentioning

confidence: 99%

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The study of screw placement parameters for Ogawa type I acromial fractures by 3D simulation

Zhang

Sun

et al. 2021

J Orthop Surg Res

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Background Acromial fractures are rare and there is no consensus on fixation, but an increasing number of studies have reported using two screws to fix Ogawa type I acromial fractures. The objective of this study was to obtain the ideal length, diameter, insertion point, and angle of the screw using a novel 3D simulation. Methods The scapular CT data of 100 individuals were obtained to reconstruct 3D models. The transparency of the 3D model was then downgraded along the axial perspective (the view perpendicular to the cross section of the acromion axis) to find the maximum translucent area. Two virtual screws were placed at the anterior edge of the acromion until they penetrated the posterior cortical bon. The largest diameters and lengths of the screw were measured, and the direction and insertion point of the screw were observed. Results The mean maximum lengths of the medial and lateral screws were 43.33 ± 6.17 mm and 39.23 ± 6.01 mm, respectively. The mean maximum diameters of the medial and lateral screws were 4.71 ± 1.23 mm and 4.97 ± 1.07 mm, respectively. Differences in screw length, diameter, and insertion point between males and females were found. The differences in screw angle between sexes were not statistically significant. Conclusions Based on a 3D model test, we recommend the size, entry points, and angles of screws for Ogawa type I acromial fractures, providing valuable guidance for clinical work. More accurate screw parameters can be obtained preoperatively by establishing an individualized 3D model.

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Nonunion of the so-called acromion: a systematic review with consideration of the terminology

Ogawa

Matsumura

Yoshida

et al. 2023

Arch Orthop Trauma Surg

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Introduction There is no widely accepted standard for the classification and treatment of traumatic acromion/scapular spine fracture nonunion due to the scarcity of this condition and the confusion of terminology. Materials and methods PubMed and Scopus were searched using “scapular fracture” and “acromion fracture” or “scapular spine fracture” as search terms. The inclusion criteria were English full-text articles concerning acromion/scapular spine fracture nonunion that described patient characteristics and presented appropriate images. The exclusion criteria were cases without appropriate images. Citation tracking was conducted to find additional articles and notable full-text articles written in other languages. Fractures were classified using our newly proposed classification system. Results Twenty-nine patients (19 men, 10 women) with 29 nonunions were identified. There were four type I, 15 type II, and 10 type III fracture nonunions. Only 11 fractures were isolated. The mean period from initial injury to final diagnosis was 35.2 ± 73.2 months (range 3–360 months) (n = 25). The most frequent cause of delayed diagnosis was conservative treatment for fracture in 11 patients, followed by oversight by the physician in 8. The most common reason for seeking medical advice was shoulder pain. Six patients received conservative therapy, and 23 received operative treatment. Fixation materials included various plates in 15 patients, and tension band wiring in 5. Bone grafting was performed in 16 patients (73%, 16/22). Of the 19 surgically treated patients with adequate follow-up, the outcome was rated excellent in 79%. Conclusions Isolated acromion/scapular spine fracture nonunion is rare. Fracture type II and III, arising in the anatomical scapular spine, accounted for 86% of the fractures. Computed tomography is required to prevent fracture oversight. Surgical therapy produces good stable results. However, it is important to select the appropriate surgical fixation method and material after considering the anatomical characteristics of the fracture and stress on the fractured portion. Level of evidence V

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Postoperative results of Ogawa type IIB meta-acromion fracture fixation with a 90° twisted reconstruction plate

Cited by 6 publications

References 27 publications

The Study of Screw Placement Parameters for Ogawa Type I Acromial Fractures by 3D Technology

The Study of Screw Placement Parameters for Ogawa Type I Acromial Fractures by 3D Technology

The study of screw placement parameters for Ogawa type I acromial fractures by 3D simulation

Nonunion of the so-called acromion: a systematic review with consideration of the terminology

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