Isolated Fracture of the Acromion Process: A Case Report

Fracture of the acromion process is an uncommon injury which is often diagnosed late. Though, usually managed conservatively, the indications for surgery in these fractures are very specific. A 52-year-old active man attended the out-patient department of our hospital following an injury to the right shoulder. An X-ray revealed a Type II, minimally displaced fracture of the base of the acromion process. Conservative management was attempted initially, which was converted to surgical stabilization after six weeks when it was noticed that the fracture had failed to unite and had progressed to become a displaced Type III fracture. Post-operative period was uneventful with a gradual return to the pre-injury level of function of the right shoulder, which was assessed by the Constant Score as well as the University of California Los Angeles (UCLA) shoulder score. The satisfaction with the final functional outcome was assessed by the UCLA shoulder score. Clinicians must look actively for acromion process fractures in all shoulder injuries. Minimally displaced fractures should be regularly followed up for displacement and sub-acromial space compromise. Although acromion fractures are usually treated conservatively, albeit a higher non-union rate, they should be treated surgically in the event of displacement or sub-acromial space reduction, in order to achieve good functional recovery.