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Acromial apophysitis.

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D A Moyes, D Mawhinney, M B Finch. 2000. Acromial apophysitis.. https://doi.org/10.1093/rheumatology%2F39.10.1164

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[Fracture of the acromion. Diagnosis--treatment strategy--outcome].

The case of an 22-year-old man is presented, who sustained a dislocated fracture of the left acromion process and a not dislocated fracture of the left scapular body with a large subcutaneous décollement as well as a dammage of nervus axillaris occurring during a traffic accident. After resuming diagnostics by means of CT, a tension banding of the ventral part of the acromion and a plate osteosynthesis of the dorsal part was performed. 7 weeks after injury neurolysis of nervus axillaris has been done. 4 months after accident the patient shows a satisfying functional result in the Constant score. Diagnostic, treatment and functional results after operative treatment of dislocated fractures of the acromion are shown and discussed.

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MRI currently offers the best imaging information for the diagnosis of subacromial pain syndrome, rotator cuff tears and osteoarthritis of the shoulder. The excellent anatomical and tissue specific imaging allows a detailed evaluation of the rotator cuff as well as the adjacent bony structures. If the cause of subacromial pain can not be determined despite extensive clinical, sonographical and radiological examination, MRI is indicated if there is a suspected pathology of the bony structures or the glenohumeral joint that could influence the further therapeutic procedures. In addition, MRI evaluation of muscular atrophy has become an important factor for determining appropriate therapy, particularly in cases of massive rotator cuff tears.

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[Total inverted shoulder prosthesis and rotator cuff insufficiency: evaluation and determination of anatomical parameters predictive of good functional outcome in 21 shoulders].

OBJECTIVE: Evaluation of the functional results of the Delta 3 inverted shoulder prosthesis and determination of a radio-anatomical index predictive of best functional outcome. PATIENTS AND METHODS: Retrospective analysis of 19 patients (21 shoulders). Clinical (pain, satisfaction, amplitudes, Constant index) and radiological (acromio-epiphyseal distance) evaluation at a mean follow up of 13.6 months. RESULTS: Outcomes concerning pain, quality of life and Constant index were good and similar to other series. Few complications were observed. An increase of the acromio-epiphyseal distance of 33 to 50% compared to the non operated side is associated with a good functional result. CONCLUSION: Our results confirm those of other series and show that Delta 3 inverted prosthesis is an efficient therapeutic alternative in arthropathy with rotator cuff tears. Rehabilitation is fairly short and easy. The increase of the acromio-epiphyseal distance determines the tension of the deltoid muscle and could predict a favorable outcome.

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