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PubMed1994

Congenital bilateral absence of the acromion. A case report.

Complete bilateral absence of the acromion, a condition not previously reported by others, was discovered in a 31-year-old housewife who had shoulder pain. Clinically, no abnormal physical sign was noted in the patient except for mild superior translation of the humeral heads. Radiographs showed bilateral absence of the lateral aspect of each scapular spine and acromion. The lateral ends of both clavicles were hypertrophied with convex and blunt margins. Even in the absence of the acromion, there was no significant clinical dysfunction of the shoulder joint.

Acromion↗
PubMed2001

Contact geometry at the undersurface of the acromion with and without a rotator cuff tear.

PURPOSE: The purpose of this study was to investigate the difference in contact geometry at the undersurface of acromion in shoulders with and without a rotator cuff (RC) tear. TYPE OF STUDY: Case-control study. METHODS: Forty fresh cadaveric shoulders (average age at death, 61 years) without gross osteoarthritic changes were divided into the intact RC group (n = 20) and the RC tear group (n = 20). Clinical impingement was simulated by compressing the humeral head and the intact portion of the RC against the coracoacromial arch with an axial compressive force of 25 kg while the humerus was held abducted 20 degrees in the scapular plane. The contact pattern between the acromion and the RC was measured with Fuji Prescale super low-pressure-sensitive film (Fuji Photo Film Co, Ltd, Tokyo, Japan). The imprint image was analyzed using Global Lab image software (Automatix, Marlboro, MA). RESULTS: The percentage of the maximum anteroposterior dimension of the imprint on Fuji film to the anteroposterior diameter of the acromial undersurface was 29% +/- 9% in intact RC shoulders, and 39% +/- 13% in shoulders with an RC tear (P >.05). The percentage of the maximum mediolateral dimension of the imprint to the mediolateral diameter of the corresponding part of the acromial undersurface was 27% +/- 12% in intact RC shoulders, and 48% +/- 11% in shoulders with an RC tear. This difference was statistically significant (P <.005). CONCLUSIONS: The contact geometry of the acromial undersurface with the underlying RC in the anteroposterior dimension, which might be related to the appearance in supraspinatus outlet view, was not significantly different between shoulders with and without an RC tear. These findings suggest that factors other than acromial shape play a significant role in the pathogenesis of RC tears. The implication regarding the role of acromioplasty remains to be clarified.

Acromion↗
PubMed1999

Symptomatic pseudarthrosis of the acromion: report of a case and review of the literature.

The case of a twenty-three-year-old male with a symptomatic pseudarthrosis of the acromion is presented. Open reduction and internal fixation with a plate, screw, and tension band construct supplemented with a bone graft was performed and early range of motion was initiated. Nine months after surgery, the fracture was healed and the patient had excellent function of the shoulder. The literature on pseudarthrosis of the acromion is reviewed.

Acromion↗
PubMed1995

Pseudarthrosis of the acromion--a differential diagnosis in anterolateral shoulder pain.

A case of longstanding posttraumatic anterolateral shoulder pain in a 25-year-old woman is presented. It was primarily unsuccessfully handled as impingement syndrome but turned out to be caused by pseudarthrosis of the acromion. The abnormality was not apparent on plain X-ray film. The suspicion was raised after scintigraphy, which showed increased density in the acromion. The diagnosis was made by computerized tomography and confirmed and treated successfully surgically.

Acromion↗
PubMed1977

Resection of the acromion in the treatment of persistent rotator cuff syndrome of the shoulder.

Partial or complete excision of the acromion was performed in 25 patients (29 shoulders) with long-standing pain in the shoulder typical of rotator cuff syndrome. There was no verified history of trauma in nine cases (13 shoulders), while injury was the cause of pain in 16 patients (16 shoulders). In nine shoulders there was a small and in two a large rupture of the rotator cuff. Twelve of the 13 non-traumatic shoulders became painless postoperatively and the pain was relieved in one. In the 16 traumatic shoulders the relief of pain was complete in six, partial in nine, and one remained unchanged. The condition was not aggravated in any of the cases. Mobility increased postoperatively in four cases and was in no case decreased by the operation. In this series the results were as favourable after partial as after complete excision of the acromion alone or excision in combination with other procedures appears to be a promising method of treatment of patients with long-standing rotator cuff syndrome.

Acromion↗
PubMed1995

Type 4 acromion: a new classification.

The three types of acromial processes previously described in the literature include type 1, in which the undersurface is straight, and types 2 and 3, in which the undersurface is concave. In this report, a fourth type of acromion is described in which the undersurface is convex near its distal end. The frequency of a type 4 acromion in the normal population is discussed based on a retrospective review of the MR examinations of 30 patients that originally were read as normal.

Acromioclavicular Joint↗
PubMed2004

Chondroblastoma of the acromion mimicking fibrous dysplasia.

The authors report the case of a 65-year-old man who presented with an expansive osteolytic lesion in the right acromion, mimicking cystic fibrous dysplasia. Magnetic resonance imaging showed a lesion with intermediate-signal intensity on T1-weighted images and a high-signal intensity on fat suppressed T2-weighted images. The biopsy led to the diagnosis of chondroblastoma. This tumour is rare in flat bones, and may mimic other benign or malignant lesions. It is therefore essential to perform a biopsy in order to obtain a definite diagnosis. The acromion was excised, and replaced with an iliac crest graft.

Acromion↗
PubMed2005

Rotator cuff impingement due to enchondroma of the acromion.

We report the case of a patient with a long standing clinical history of subacromial impingement, in which plain radiographs and CT-scan revealed a well-circumscribed lucent lesion expanding the undersurface of the acromion. MRI showed the subacromial fat to be completely obliterated and the infraspinatus tendon deformed due to compression by a mass localised at the acromion. The acromial lesion was curetted, and histopathologic analysis was consistent with the diagnosis of enchondroma. Tumours located in the coracoacromial arch have been very rarely reported as a cause of subacromial impingement. To the best of our knowledge, this is the first description of subacromial impingement secondary to acromial enchondroma.

Acromion↗
PubMedDate not supplied

Fracture of the acromion associated with an axillary nerve deficit: a case report and review of the literature.

Fractures of the scapula are rare injuries, and fractures of the acromion comprise only a small percentage of this group. An unusual fracture through the base of the acromion with an acromioclavicular separation is described in this paper. The segmental acromial injury had an associated isolated axillary nerve deficit to deltoid muscle. The above-described 51-year-old patient is presented to make the clinician aware of potential neurologic complications associated with acromial fractures.

Acromioclavicular Joint↗
PubMed1995

Aneurysmal bone cyst of the acromion: a case report.

The case of 6-year-old girl with an asymptomatic aneurysmal bone cyst of the acromion is reported. Such tumors are rarely located in the scapula and are especially rare in the acromion. The diagnosis was confirmed by biopsy and surgical resection of the lesion. Roentgenographic, CT and histologic features of the cyst are discussed.

Acromion↗
PubMed1995

Chondroblastoma of the acromion.

We describe a rare case of chondroblastoma of the acromion in a 29-year-old man. In addition to the radiological progression and confirmatory histological evidence of the lesion, the relevant and more unusual aspects of this tumour are discussed.

Acromion↗
PubMed1996

Traumatic posterior dislocation of the shoulder with fracture of the acromion in a child.

Posterior dislocation of the shoulder is extremely rare in children. We encountered a posterior dislocation of the shoulder complicated by fracture of the acromion in a 14-year-old boy. He recovered uneventfully after immediate manual reduction performed under general anesthesia and truncal plaster cast fixation. Early diagnosis and treatment are considered to be especially important in managing this injury.

Acromion↗
PubMed1998

The anterior tilt of the acromion: radiographic evaluation and correlation with shoulder diseases.

The aim of this study was to test whether the anterior tilt of the acromion can be objectively evaluated on lateral radiographs, and whether there is a relation between this anatomical feature and the most common shoulder diseases. Lateral radiographs of 15 dried scapulas were performed in neutral position and with 5 degrees of caudal, cranial, anterior and posterior angulations. Two hundred and forty-three shoulders, both asymptomatic and affected by chronic and post-traumatic impingement, calcific tendinitis and instability, were examined by conventional radiography. The presence of rotator-cuff tears was investigated by sonography. A method was elaborated to obtain reproducible lateral radiographs and to determine the acromial tilt angle. Inter- and intraobserver and inter- and intraoperator variations in measurements were evaluated. Variations in tube angulation produced changes in tilt-angle values on dried scapulas. The average tilt angle for the chronic impingement and the instability groups were significantly different from the post-traumatic, calcific tendinitis and control groups. Rotator-cuff tears were significantly more frequent in the chronic impingement group and related to a more acute tilt angle. The inter- and intraobserver variability coefficients were 0.95 and 0.98, whereas the inter- and intraoperator variability coefficients were 0.94 and 0.96, respectively. Conventional radiography using fluoroscopy for positioning is a well-reproducible method for the evaluation of acromial tilt. There is a significant difference in tilt-angle values between some groups of subjects examined, but the lack of specificity limits the clinical importance of such measurement.

Acromion↗
PubMed1994

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.

Acromion↗