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Os Acromiale

Topic updated on 01/15/14 1:52pm
Introduction
  • An unfused secondary ossification center 
    • most common location is the junction of meso- and meta-acromion  
    • important to distinguish an os acromiale from fractures of the acromion
  • Epidemiology
    • incidence 8%
    • bilateral in 60%
  • Associated conditions
    • shoulder impingement
    • rotator cuff disease
  • Prognosis
    • poorer outcomes after rotator cuff repairs in patients with meso-os acromiale 
Anatomy
  • 3 ossification centers  
    • meta-acromion (base)
    • meso-acromion (mid)
    • pre-acromion (tip)
Presentation
  • May present with signs and symptoms of impingement
Imaging
  • Radiographs
    • recommended views
      • best seen on an axillary lateral of the shoulder 
Treatment
  • Nonoperative
    • observation and therapy
      • indications
        • mild symptoms
  • Operative
    • two-stage fusion and acromioplasty
      • indications
        • symptomatic os acromiale with impingement
      • technique
        • direct excision can lead to deltoid dysfunction
        • a two-stage procedure may be required
          • first fuse the os acromiale with bone graft
          • in a second procedure perform an acromioplasty

 

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Qbank (1 Questions)

TAG
(OBQ07.156) A 22-year-old man presents with shoulder pain. Radiographs are shown in Figure A and B. What is the most likely cause? Topic Review Topic
FIGURES: A   B        

1. acute acromial fracture
2. type IV acromioclavicular separation
3. deltoid avulsion
4. failure of fusion between the meso-acromion and pre-acromion
5. failure of fusion between the meso-acromion and meta-acromion

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Educational presentation discussing issues with the acromion
9/2/2013
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Sammarco VJ
J Bone Joint Surg Am. 2000 Mar;82(3):394-400. PMID: 10724231 (Link to Pubmed)
7/4/2014
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