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Symptomatic os acromiale.

Christopher A Kurtz1, Byron J Humble, Mark W Rodosky

  • 1Division of Sports Medicine, Department of Orthopaedic Surgery, Naval Medical Center, VA, USA.

The Journal of the American Academy of Orthopaedic Surgeons
|January 6, 2006
PubMed
Summary

Os acromiale, an anatomical variant, can cause shoulder impingement and rotator cuff tears. Surgical options like excision or fixation are considered when conservative treatments fail.

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Area of Science:

  • Orthopedic Surgery
  • Anatomy
  • Sports Medicine

Background:

  • Os acromiale is an anatomical variant where the acromion joins the scapular spine via fibrocartilage, affecting ~8% of the population.
  • This variant is more prevalent in Black individuals and males.
  • While often incidental, os acromiale can lead to shoulder impingement and rotator cuff tears.

Purpose of the Study:

  • To review the clinical significance and management options for symptomatic os acromiale.
  • To discuss surgical interventions for os acromiale when non-surgical methods fail.

Main Methods:

  • Literature review of studies on os acromiale prevalence, pathology, and treatment outcomes.
  • Analysis of surgical techniques including excision, open reduction and internal fixation (ORIF), and arthroscopic decompression.

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Main Results:

  • Surgical options for symptomatic os acromiale include excision, ORIF, and arthroscopic decompression.
  • Excision is suitable for smaller fragments, while ORIF preserves deltoid function for larger fragments.
  • Cannulated screw fixation shows good union rates; arthroscopic techniques for unstable os acromiale yield mixed results.

Conclusions:

  • Symptomatic os acromiale requires careful consideration of management strategies.
  • ORIF is preferred for larger fragments to maintain deltoid function.
  • Associated rotator cuff tears can be managed concurrently with os acromiale fixation.