• Title/Summary/Keyword: Acromion fracture

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Spontaneous Healing of Acromial Stress Fracture Caused by Clavicle Hook Plate in Acromioclavicular Joint Dislocation - A Case Report

  • Kim, Gang-Un;Kim, Seong-Hwan;Lee, Jae-Sung;Kim, Jae Yoon
    • Clinics in Shoulder and Elbow
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    • v.17 no.1
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    • pp.36-39
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    • 2014
  • Clavicular hook plate is known to be an effective treatment on acromioclavicular (AC) joint injury, but there have been some reports of complications, like osteolysis and bony erosion of the undersurface of acromion. Fifty-five year old male underwent open reduction and hook plate insertion on Rockwood type 5 acromioclavicular joint dislocation. He complained of protrusion of posterior acromion at 1 month after the surgery, and acromial fracture was noted in simple radiographs. The hook plate was removed and any other treatment for osteosynthesis was refused by the patient. At the 18 months after the surgery, the patient had no pain and a full range of motion with no tenderness around the shoulder joint. After two years, plain radiographs revealed complete bony union of the acromion fracture.

Acromion Fracture after Hook Plate Fixation for Distal Clavicle Injury: A Report of 2 Cases

  • Kang, Suk;Lee, Ho Min;Back, In Hwa
    • Clinics in Shoulder and Elbow
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    • v.19 no.3
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    • pp.168-171
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    • 2016
  • Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.

Scapular spine base fracture with long outside-in superior or posterior screws with reverse shoulder arthroplasty

  • Eroglu, Osman Nuri;Husemoglu, Bugra;Basci, Onur;Ozkan, Mustafa;Havitcioglu, Hasan;Hapa, Onur
    • Clinics in Shoulder and Elbow
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    • v.24 no.3
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    • pp.141-146
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    • 2021
  • Background: The purpose of the present study was to determine how long superior screws alone or in combination with posterior placement of metaglene screws protruding and penetrating into the scapular spine in reverse total shoulder arthroplasty affect the strength of the scapular spine in a fresh cadaveric scapular model. Methods: Seven fresh cadaver scapulas were allocated to the control group (short posterior and superior screws) and seven scapulars to the study group (spine base fixation with a four long screws, three with both long superior and long posterior screws). Results: The failure load was lower in the spine fixation group (long screw, 869 N vs. short screw, 1,123 N); however, this difference did not reach statistical significance (p>0.05). All outside-in long superior or superior plus posterior screws failed due to scapular spine base fracture; failures in the short screw group were due to acromion fracture. An additional posterior outside-in screw failed to significantly decrease the failure load of the acromion spine. Conclusions: The present study highlights the significance of preventing a cortical breach or an outside-in configuration when a superior or posterior screw is inserted into the scapular spine base.

Bilateral acromial stress fractures in a patient with a massive rotator cuff tear

  • Kim, Du-Han;Na, Sang-Soo;Baek, Chung-Sin;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • v.23 no.2
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    • pp.105-108
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    • 2020
  • Stress fractures of the acromion and scapular spine are well-known complications following reverse total shoulder arthroplasty. However, these fractures in patients with massive rotator cuff tear or cuff tear arthropathy are extremely rare, and the pathogenesis, clinical features, diagnosis, and treatment of these fractures are poorly understood. We report a case of bilateral stress fracture of the posterior angle of the acromion in a patient with massive rotator cuff tear and discuss the pathogenesis, clinical manifestation, and treatment with a review of the literature.

Acute Displaced Fracture of Lateral Acromion after Reverse Shoulder Arthroplasty: A Case Report and Surgical Technique

  • Cho, Chul-Hyun;Jung, Jae-Won;Lim, Young-Jae;Na, Sang-Soo;Kim, Du-Han
    • Clinics in Shoulder and Elbow
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    • v.22 no.2
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    • pp.106-109
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    • 2019
  • Acromial fractures are well-documented complications subsequent to reverse shoulder arthroplasty (RSA), and most appear as stress fractures with no history of single trauma. To date, no study has reported the occurrence of acute displaced acromial fracture due to sudden strong deltoid contraction during heavy work. Displacement of the fracture results in a challenging surgery since it is difficult to obtain adequate fixation in thin and osteoporotic bones. We report a rare case of acute displaced acromial fracture after successful RSA treatment, using a novel technique of open reduction and internal fixation, applying two 4.5 mm cannulated screws and lateral clavicle precontoured plate.

Internal Fixation for Isolated Posterolateral Fracture of the Acromion - A Case Report - (단독 후외측 견봉 골절에 대한 내고정술 - 증례 보고 -)

  • Kwon, Young-Ho;Jung, Gu-Hee;Cha, Sang-Won
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.62-65
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    • 2008
  • Isolated acromial fracture is not common and it frequently accompanies fractures to the coracoid process and glenoid bone and also injuries to the acromioclavicular joint. Furthermore, most of these combined acromial fractures have minimal displacement, which needs no additional treatment other than protection for a certain period of time. We have experienced a case of isolated fracture of the posterolateral angle of the acromion, which we reduced and fixated using K-wire and cannulated screws. We report on the technical aspects and clinical results of this reduction and fixation, along with a review of the literature.

Crossbar Technique for the Failed Clavicular Hook Plate Fixation in an Acute Acromioclavicular Joint Dislocation: Salvage for Acromial Fracture after Clavicular Hook Plate

  • Koh, Kyoung Hwan;Shin, Dong Ju;Hwang, Seong Mun
    • Clinics in Shoulder and Elbow
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    • v.22 no.3
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    • pp.149-153
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    • 2019
  • We experienced acromial erosion and subsequent fracture after the treatment of Rockwood type V acromioclavicular dislocation with hook plate and coracoclavicular ligament augmentation. It was treated by using a surgical technique to address an acromial fracture and subsequent losses of reduction in acromioclavicular joint with two trans-acromial cortical screws (crossbar technique). The reduction state of acromioclavicular joint could be maintained by these two screws. Our crossbar technique could be considered as a good salvage procedure for the reduction loss caused by cutout or significant erosion of acromion after insertion of clavicular hook plate.

Internal Fixation Using Clavicle Hook Plates for Distal Clavicle Fractures

  • Kim, Kwang-Yul;Kim, Hyung-Chun;Cho, Sung-Jun;Ahn, Su-Han;Kim, Dong-Seon
    • Clinics in Shoulder and Elbow
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    • v.18 no.1
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    • pp.21-27
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    • 2015
  • Background: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. Methods: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. Results: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. Conclusions: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.

Shoulder Impingement Caused by Superiorly Displaced Glenoid Fracture Fragment at a Boy - A Case Report - (소아에서 생긴 견갑골 관절와 골절편의 상방 전위에 의한 견관절 충돌 운동 장애 - 증례 보고 -)

  • Jeong, Kyoung-Il;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Choi, Hun-Sik;Park, Gee-Kang
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.231-234
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    • 2006
  • We experienced a case of impingement caused by a bone fragment which was impacted between acromion and humeral head in a child. The bone fragment came from antero-inferior glenoid fracture. Satisfactory clinical results and stability were obtained by arthroscopic bone fragment removal. In case that bone fragment is located in the upper shoulder joint and results in impingement, We must consider not only greater tubercle fracture but also glenoid fracture. Magnetic resonance imaging can assist in the preoperative diagnosis.

Treatment of Pseudoarthrosis due to Nonunion of the Acromial Fracture with LCP - Case Report - (견봉 골절의 불유합으로 기인한 가관절증의 잠김 금속판을 이용한 치료 - 증례보고 -)

  • Kim, Yong-Min;Park, Kyoung-Jin;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Cho, Byung-Ki;Park, Ji-Kang;Keum, Sang-Wook;Jeong, Ho-Seung
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.130-134
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    • 2013
  • A painful pseudoarthrosis will develop due to a delay in diagnosis and treatment, and surgical care is required. Treatment of pseudoarthrosis is really difficult because the acromion is a thin flat bone that is difficult to be fixed firmly. A 52-year-old woman with multiple trauma had an acromial fracture that was not detected until it had caused pain after ambulation. Open reduction and internal fixation with a variable angle locking compression plate for distal radius and autogenous iliac bone graft were performed. At nine months after the operation, there was partial tear in the supraspinatus tendon, and arthroscopic repair of the supraspinatus tendon was performed. At nine months after the operation, radiographs showed a complete union. At three months after tendon repair, the patient had excellent function of the shoulder. We have reported a case of a successful treatment of nonunion and pseudoarthrosis of acromial fracture that is difficult to be fixed.