Management of Os Acromiale

摘要

Os acromiales occur with an incidence between 7% and 8%. They can result in dynamic impingement on the rotator cuff and be symptomatic. Although symptomatic pre-acromions can be excised, the excision of larger os acromiales may result in poor deltoid biomechanics and functional loss. The authors favor arthroscopic examination to determine os stability followed by open reduction of a meso-acromion or meta-acromion with bone grafting and internal fixation using 4.0-mm cannulated screws and 18-gauge wire. The earlier experience of nonunion has largely been avoided by abandoning K-wire fixation for cannulated screws. We have achieved union in 13 of the 15 cases of os acromiales treated in this manner Complications are nearly always related to symptomatic prominent hardware that can be ameliorated by staged hardware removal after healing of the bone grafted os acromiale.