Hamid Nady, Connor Patrick M, Fleischli James F, D'Alessandro Donald F
Sports and Shoulder/Elbow Center, OrthoCarolina, Charlotte, North Carolina, USA.
Am J Orthop (Belle Mead NJ). 2011 Jul;40(7):E125-9.
In this article, we report on our experience with patients who sustained a fracture of the acromion after reverse shoulder arthroplasty (RSA), and on the results of a comprehensive survey regarding this complication- a survey of American Shoulder and Elbow Surgeons (ASES) members. Patients were assessed with radiographs and validated functional outcome measures. Eight (4.9%) of the 162 patients that underwent RSA had radiographic evidence of postoperative fracture of the acromion. Mean active forward elevation was 71°, and mean ASES score was 70. Four patients reported no pain; 2 had mild pain; 1 had moderate pain; and 1 patient had severe pain. Six of the 8 fractures did not unite. Survey results showed that 74% of ASES respondents treated these patients nonoperatively and that 53% of respondents thought that acromial fractures after RSA led to reduced shoulder function, but without persistent pain. The natural history of nonoperative management is characterized by reduced global shoulder function and a high rate of nonunion. However, most of the patients who experienced this complication did not report chronic pain. Given these patients' outcomes, and the surveyed opinions of ASES members, conservative management is a reasonable option for this complication.
在本文中，我们报告了我们对接受反式肩关节置换术（RSA）后发生肩峰骨折患者的治疗经验，以及关于这一并发症的全面调查结果——一项针对美国肩肘外科医师学会（ASES）成员的调查。通过X线片和经过验证的功能预后指标对患者进行评估。在接受RSA的162例患者中，有8例（4.9%）有术后肩峰骨折的影像学证据。平均主动前屈角度为71°，ASES平均评分为70分。4例患者报告无疼痛；2例有轻度疼痛；1例有中度疼痛；1例患者有重度疼痛。8例骨折中有6例未愈合。调查结果显示，74%的ASES受访者对这些患者采取非手术治疗，53%的受访者认为RSA后肩峰骨折会导致肩关节功能下降，但无持续性疼痛。非手术治疗的自然病程特点是肩关节整体功能下降和不愈合率高。然而，大多数发生这一并发症的患者并未报告慢性疼痛。鉴于这些患者的治疗结果以及ASES成员的调查意见，保守治疗是处理这一并发症的合理选择。
