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Fractures of the acromial process or coracoid process of the scapula are rare. We present a combined fracture of the coracoid and acromion after direct trauma to the shoulder. An anteroposterior radiography with the central x-ray beam angled 25 degrees cephalad or an axillary lateral radiograph may be needed to detect these fractures.
We report a case involving combined acromion fracture and posterior glenohumeral dislocation. To our knowledge, this combination of injuries has not been reported previously in the literature. In our case, the shoulder dislocation was initially missed. The utility of additional radiographic views to detect this type of injury is emphasized. The mechanism of injury, course of treatment, and clinical outcome are presented.
Fractures of the acromion are rare. Conservative therapy in the majority of cases results in return to full function of the shoulder. Occasionally, however, a painful pseudoarthrosis will develop and surgical care is required. The American literature reports several cases of acromial fracture but has not specifically addressed the treatment of pseudoarthrosis with open reduction and internal fixation. We report such a case and review the American and European literature.
We examined 200 scapular bones for signs of degenerative changes in the coraco-acromial arch. The slope and length of the acromion and the height of the arch were found to be most closely associated with degenerative change. These anatomical features are not significantly altered by current techniques of subacromial decompression.
A number of fibrous lesions involving bone display almost identical histologic appearances yet may represent either reactive or neoplastic conditions, resulting in a confusing nomenclature and possible diagnostic confusion. We report the case of a young man with no significant previous medical history who presented with a painful lesion in the left shoulder, which consisted almost entirely of xanthomatous material. We discuss the possible differential diagnosis of this lesion and why benign fibrous histiocytoma is the preferred terminology for this lesion. To our knowledge, this is the first reported case of a benign fibrous histiocytoma involving the acromion in an adult.
Examination was made of 750 scapular dry bone specimens from museum collections and 80 cadaver shoulders. Hooking of the acromion was not found in subjects under the age of 30 years. The hooked configuration developed at later ages in an increasing proportion of subjects as a result of calcification of the acromial attachment of the coracoacromial ligament.
The author made an electromyographic investigation of reflex responses in the abductor pollicis brevis muscle abductor pollicis brevis muscle after percussion with a hammer on the dorsal, lateral, palmar, medial and distal surface of the distal digit of the thumb, on the dorsal and palmar area of the distal digits of the other fingers and also on the olecranon ulnae and acromion scapulae. The investigation was made to detect the influence of the site of percussion on the character of the reflex response. The reflex responses were examined during slight isometric contraction of the muscle. After averaging rectification and of the recorded potentials the reflex responses were identified as excitatory and inhibitory modulation of the basal muscular activity depending on the inducing stimulus. Excitatory parts of the reflex response with a short latency were recorded after percussion on the lateral, dorsal and palmar area of the distal digit of the thumb and after percussion of the dorsal area of distal digits of the other fingers and after percussion of the palmar area of the little finger. As to other sites where reflexes were evoked first the inhibitory part of the reflex response was recorded. Excitation parts of reflex responses with a medium latency were obtained from all sites where reflexes were evoked. Late-latency parts of the reflex response had an inconstant occurrence. The results of the investigation provided evidence of a short-latency proprioceptory; influence of the abductor pollicis brevis muscle from synergic muscles.(ABSTRACT TRUNCATED AT 250 WORDS)
We describe a patient with the rare autosomal dominant syndrome of congenital glenoid dysplasia. The severity of the findings resulted in an intense and effective radiological and clinical work-up including MRI, CT reconstruction, and fluoroscopy.
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The ultrastructural features of a malignant histiocytoma of the acromial process of the scapula were studied. Material was obtained from two surgical biopsy specimens and an amputation specimen from the tumor. Cells possessing characteristics of histiocytes, fibroblasts, xanthoma cells, and multinucleated giant cells were present throughout the tumor. Smaller numbers of undifferentiated cells and lymphocytes were also observed. Intimate cytoplasmic interdigitations between adjacent tumor cells were found, and instances of degenerating intracytoplasmic cells, possibly representing phagocytosis, were observed. Specimens stained with periodic acid-Schiff reagent with and without exposure to diastase, examined by light microscopy, showed that numerous cells contained phagocytized material consisting of degenerating cells rather than cytoplasmic glycogen. Intraumor lymphocytes apparently represented an inflammatory reaction to the tumor. The tumor giant cells and xanthoma cells were probably modified histiocytes. Results of the study were compared with previous reports of ultrastructural studies of malignant histiocytoma of soft tissues. Fundamental similarities between such studies and this one suggested that the progenitor cell is a histiocyte, whether arising in bone or in soft tissues, and that the progenitor cell is capable of differentiation in both histiocytic and fibroblastic directions.
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