A. Atan, Zamri Abdul Rahman, Norhaslinda Bahaudin, K. R. Zayzan, A. Ahmad
{"title":"Intramedullary Screw Fixation Supplemented by Scapular Spine Plating: A Surgical Technique for the Base of Acromion Fracture","authors":"A. Atan, Zamri Abdul Rahman, Norhaslinda Bahaudin, K. R. Zayzan, A. Ahmad","doi":"10.1097/BTE.0000000000000202","DOIUrl":null,"url":null,"abstract":"Isolated acromion fractures, although unusual, are not uncommon. Traditionally treated conservatively, an improved understanding of shoulder biomechanics has extended the indications for surgical treatment. Surgical modalities described in the literature are plating, cortical lag screw, Kirschner wiring, and tension-band wiring. We describe a novel surgical technique for both fixation of an acute fracture or revision surgery of the base of acromion fracture. The technique involves the insertion of an intramedullary screw from the lateral tip of the acromion toward the tapered medial part of the scapular spine. This is supplemented by an anatomic locking reconstruction plating placed on the superior border of the acromion and scapular spine. We share an illustrated case of a 39-year-old woman, who successfully underwent a revision surgery with this technique and recovered well with excellent radiologic and functional outcomes. A long intramedullary screw provides good interfragmentary compression, 3-point fixation, and better bony purchases. A supplementary plate helps to resist rotational and muscular-pulling forces. In conclusion, intramedullary screw fixation, supplemented with plating, offers a viable surgical treatment for acromion fractures, and combined with a proper postoperative rehabilitation regime, it helps patients to achieve","PeriodicalId":44224,"journal":{"name":"Techniques in Shoulder and Elbow Surgery","volume":null,"pages":null},"PeriodicalIF":4.5000,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Shoulder and Elbow Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/BTE.0000000000000202","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"EDUCATION & EDUCATIONAL RESEARCH","Score":null,"Total":0}
引用次数: 0
Abstract
Isolated acromion fractures, although unusual, are not uncommon. Traditionally treated conservatively, an improved understanding of shoulder biomechanics has extended the indications for surgical treatment. Surgical modalities described in the literature are plating, cortical lag screw, Kirschner wiring, and tension-band wiring. We describe a novel surgical technique for both fixation of an acute fracture or revision surgery of the base of acromion fracture. The technique involves the insertion of an intramedullary screw from the lateral tip of the acromion toward the tapered medial part of the scapular spine. This is supplemented by an anatomic locking reconstruction plating placed on the superior border of the acromion and scapular spine. We share an illustrated case of a 39-year-old woman, who successfully underwent a revision surgery with this technique and recovered well with excellent radiologic and functional outcomes. A long intramedullary screw provides good interfragmentary compression, 3-point fixation, and better bony purchases. A supplementary plate helps to resist rotational and muscular-pulling forces. In conclusion, intramedullary screw fixation, supplemented with plating, offers a viable surgical treatment for acromion fractures, and combined with a proper postoperative rehabilitation regime, it helps patients to achieve
期刊介绍:
Published quarterly, Techniques in Shoulder & Elbow Surgery escorts the reader into the operating room and supplies step-by-step details of exciting and advanced techniques. It explains the evolution of and rationale for the procedures, identifies the pitfalls and possible complications, provides invaluable tips for improving surgical results and it is illustrated cover to cover with high-quality intraoperative photographs and drawings, many in full color.