Fractures of the acromion in tetanus neonatorum [corrected]

Avulsion fractures of the acromion [corrected] are described in 10 patients with severe tetanus neonatorum. Typically bilateral and invariably contemporaneous, they result from isometric contraction. Forced abduction of the arm against adductor resistance leads to avulsion of that segment of the acromium where the multipenate fibres of the deltoid muscle originate. To our knowledge this unique and ominous orthopaedic complication of severe neonatal tetanus has not been documented previously.