Operative Fixation of a Lateral Acromion Fracture in a Native Shoulder Using Nice Knot Suture Cerclage

Acromion fractures are challenging injuries to manage. Nonoperative treatment for nondisplaced fractures can yield satisfactory outcomes for most patients. Displaced acromion fractures can be difficult to manage given the vector of displacement and limited bone for fixation. There is no consensus on surgical approach to these fractures as they are rare. Acromion fractures in native shoulders are rarer as most acromion fractures are secondary to altered mechanics and decreased bone mineral density following reverse shoulder arthroplasty. The acromion is a thin and flat bone making plate and screw fixation challenging. This technical note describes a technique for open reduction and internal fixation of a lateral acromion fracture in a native shoulder utilizing Nice knot suture cerclage.