Acromial Fracture Associated with Coracoid Fracture Not Belong to Floating Shoulder : A Case Report

Floating shoulder is no osseoligamentous connection between the humeral shoulder joint with the axial skeleton. The osseoligamentous of shoulder joint connection compose a ring, including clavicle,acromion, coracoid, glenoid fossa, surgical or anatomical scapula neck, acromioclavicular ligament and coracolclavicular ligament. This ring is known as superior shoulder suspensory complex (SSSC). The double disruptions of this ring are recognized to create a potentially unstable anatomical situation. Thus, floating shoulder is also characterized as double or more disruptions of SSSC. Surgical reduction and fixation for the displacement of those fractures at one or more sites is recommended in previous reports. We present 2 cases of patients with acromial and coracoid displaced fractures which belong to a type of the double disruptions of SSSC, there were still osseoligamentous connection between the humeral shoulder joint with the axial skeleton. The patient’s shoulder function after nonoperative management was satisfactory.

Modified technique of Indirect arthroscopic distal clavicle resection

Distal clavicle resection is an accepted surgical treatment option for unremitting acromioclavicular joint arthritis. Indirect arthroscopic approach is preferred when an additional subacromial or glenohumeral diagnostic or therapeutic procedure is contemplated. However, concomitant subacromial decompression and acromial overhang removal, which is integral to indirect approach vis-a-vis direct approach, have additional risks of stiffness and acromial fracture. A modification in indirect approach technique is demonstrated which not only reduces these risks but also improves accuracy and safety of distal clavicle resection. The pros and cons are discussed in detail with reference to relevant literature.

Acromion Fracture and Acromioclavicular Joint Dislocation: A Case Report

Background: Acromion fractures are rare injuries that may occur because of shoulder trauma. This may be associated with distal clavicle fractures, which can be an indication for surgery. There are several methods, which are used for fixation of this type of fractures. Case Presentation: In this paper, we presented a 34 years old man with acromion fracture in contribution with acromioclavicular (AC) joint dislocation. We applied a new method for fixation of this fracture. The fracture was fixed by 2 screws and AC Joint was fixed by a 4-hole hook plate. Conclusions: It is important to be aware of acromial fracture to not miss them and also for early management, so that early recovery and satisfactory results can be gained

Acromial fracture after reverse total shoulder arthroplasty: a systematic review

Background The reverse total shoulder arthroplasty has become the most common method of arthroplasty of the shoulder. The complication of acromial or scapular stress fracture deserves consideration to describe incidence and determine whether prosthetic design or patient factors act as risk factors. Methods A systematic review of the literature was performed including the EMBASE, Medline and the Cochrane Library in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results The search returned 565 articles. After exclusion, 25 papers remained. In total, 208 fractures were reported in the literature, with an overall incidence of 5% and stress fractures were more common than post-traumatic ones; 24 fractures underwent osteosynthesis and there were nine revision arthroplasty surgeries. Outcomes worsened after fracture – whether treated with surgery or not. In patients with scapular base fractures, there was an improvement in functional outcome scores after surgery. Heterogeneous reporting of the risk factors prior to fractures, treatment methods and outcomes made recommendations weak. Discussion Acromial stress fracture after reverse total shoulder arthroplasty occurs relatively commonly but is poorly reported in the literature. It is unclear whether immobilisation, fixation or revision arthroplasty is the best treatment, although fixation may offer a better outcome. In future, reports should aim for greater consistency to allow a better understanding of this condition.

Crossbar Technique for the Failed Clavicular Hook Plate Fixation in an Acute Acromioclavicular Joint Dislocation: Salvage for Acromial Fracture after Clavicular Hook Plate

We experienced acromial erosion and subsequent fracture after the treatment of Rockwood type V acromioclavicular dislocation with hook plate and coracoclavicular ligament augmentation. It was treated by using a surgical technique to address an acromial fracture and subsequent losses of reduction in acromioclavicular joint with two trans-acromial cortical screws (crossbar technique). The reduction state of acromioclavicular joint could be maintained by these two screws. Our crossbar technique could be considered as a good salvage procedure for the reduction loss caused by cutout or significant erosion of acromion after insertion of clavicular hook plate.

Acute Displaced Fracture of Lateral Acromion after Reverse Shoulder Arthroplasty: A Case Report and Surgical Technique

Acromial fractures are well-documented complications subsequent to reverse shoulder arthroplasty (RSA), and most appear as stress fractures with no history of single trauma. To date, no study has reported the occurrence of acute displaced acromial fracture due to sudden strong deltoid contraction during heavy work. Displacement of the fracture results in a challenging surgery since it is difficult to obtain adequate fixation in thin and osteoporotic bones. We report a rare case of acute displaced acromial fracture after successful RSA treatment, using a novel technique of open reduction and internal fixation, applying two 4.5 mm cannulated screws and lateral clavicle precontoured plate.