Intramedullary Screw Fixation Supplemented by Scapular Spine Plating: A Surgical Technique for the Base of Acromion Fracture

IF 4.5 Q1 EDUCATION & EDUCATIONAL RESEARCH Techniques in Shoulder and Elbow Surgery Pub Date : 2020-12-01 DOI:10.1097/BTE.0000000000000202
A. Atan, Zamri Abdul Rahman, Norhaslinda Bahaudin, K. R. Zayzan, A. Ahmad
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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
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肩胛骨钢板加髓内螺钉固定:一种治疗肩峰基部骨折的手术技术
孤立的肩峰骨折,虽然不常见,但并不罕见。传统的保守治疗,肩部生物力学的理解的提高扩大了手术治疗的适应症。文献中描述的手术方式有电镀、皮质拉力螺钉、克氏针连接和张力带连接。我们描述了一种新的手术技术,既固定急性骨折或修复手术的肩峰骨折的基础。该技术包括从肩峰外侧尖端向肩胛骨锥形内侧插入一枚髓内螺钉。在肩峰和肩胛骨的上缘放置解剖锁定重建钢板作为补充。我们分享一个39岁女性的病例,她成功地接受了该技术的翻修手术,并恢复良好,放射学和功能预后良好。长髓内螺钉提供良好的碎片间压缩、三点固定和更好的骨购买。辅助板有助于抵抗旋转和肌肉拉扯力。综上所述,髓内螺钉内固定配合钢板是治疗肩峰骨折的一种可行的手术方法,并结合适当的术后康复方案,可帮助患者达到
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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.
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