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Optimal management of symptomatic os acromiale: current perspectives
Ulrich J Spiegl1, Peter J Millett2, Christoph Josten1
1Department of Orthopedics, Trauma Surgery and Plastic Surgery, University of Leipzig, Leipzig, Germany, uli.spiegl@gmx.de.
Orthopedic Research and Reviews
|February 19, 2019
Summary
Os acromiale, a common shoulder anomaly, is usually asymptomatic. Symptomatic cases may mimic impingement and require diagnosis via imaging and physical exam, with surgery considered for persistent pain or instability.
Area of Science:
- Orthopedics
- Sports Medicine
- Anatomy
Background:
- Os acromiale is a common, unfused ossification center of the acromion.
- It is frequently asymptomatic but can be a source of shoulder pain.
- It can mimic symptoms of shoulder impingement syndrome.
Purpose of the Study:
- To review the diagnosis and management of symptomatic os acromiale.
- To outline surgical indications and techniques for os acromiale.
- To discuss treatment options based on os acromiale type.
Main Methods:
- Diagnosis involves physical examination, conventional radiography, MRI, and selective anesthetic injections.
- Treatment strategies range from conservative management to surgical intervention.
- Surgical options include excision and open or arthroscopic reduction and internal fixation.
Main Results:
- Symptomatic os acromiale requires a comprehensive diagnostic approach.
- Surgical treatment is reserved for cases unresponsive to conservative therapy or with significant instability/pathology.
- Internal fixation, particularly with cannulated screws and tension bands, offers biomechanical advantages for meso-type os acromiale.
Conclusions:
- Os acromiale diagnosis is crucial in patients with shoulder pain and impingement-like symptoms.
- Treatment selection depends on symptom severity, stability, associated pathologies, and os acromiale type.
- Internal fixation provides a reliable option for unstable or symptomatic meso-type os acromiale.
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