Isolated Acromion Fracture: A Case Report
Kyle P. Stephenson, DO, MSa, Douglas Dietzel, DOa,b
aMcLaren-Greater Lansing Orthopedic Hospital, Lansing, MI, USA
bMichigan State University Sports Medicine, East Lansing, MI, USA
Isolated acromion fractures are rare in the literature. Moreover, the majority of these fractures are treated nonoperatively. The purpose of this case report is to present surgical indications, our surgical technique, and clinical follow-up in a rare orthopedic issue. It also gives insight on the prognosis of this injury.
We report on a 56-year-old male with an isolated acromial fracture after a snowmobile accident. The fracture resulted in subacromial impingement and displacement > 1 cm, therefore the decision was made for operative fixation. A posterior approach of the scapula was used and open reduction and internal fixation with a reconstruction plate was performed.
Excellent functional outcome was achieved in regard to shoulder range of motion, strength, and retained subacromial space. At two months postoperatively, his ROM improved to 1750 of flexion, 1750 abduction, 650 external rotation, and internal rotation/extension to L4. Strength progressed to 5/5 in all planes. At his one-year follow-up, this patient denied pain and demonstrated full ROM and 5/5 strength. Both ROM and strength are symmetric with the contralateral upper extremity. He returned to work full-time without restrictions.
Although this injury is rarely seen and often treated nonoperatively, surgery may be performed to prevent rotator cuff tears secondary to subacromial impingement, painful nonunions or malunions, and decreased overall function of the shoulder.
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