Bhaduri Indranil, Thakur Rajesh, Kumar Sachin, Rajak Manoj K
Department of Joint Replacement and Orthopedics, Tata Main Hospital, Jamshedpur, IND.
Cureus. 2021 Mar 22;13(3):e14032. doi: 10.7759/cureus.14032.
Fracture of the acromion process is an uncommon injury which is often diagnosed late. Though, usually managed conservatively, the indications for surgery in these fractures are very specific. A 52-year-old active man attended the out-patient department of our hospital following an injury to the right shoulder. An X-ray revealed a Type II, minimally displaced fracture of the base of the acromion process. Conservative management was attempted initially, which was converted to surgical stabilization after six weeks when it was noticed that the fracture had failed to unite and had progressed to become a displaced Type III fracture. Post-operative period was uneventful with a gradual return to the pre-injury level of function of the right shoulder, which was assessed by the Constant Score as well as the University of California Los Angeles (UCLA) shoulder score. The satisfaction with the final functional outcome was assessed by the UCLA shoulder score. Clinicians must look actively for acromion process fractures in all shoulder injuries. Minimally displaced fractures should be regularly followed up for displacement and sub-acromial space compromise. Although acromion fractures are usually treated conservatively, albeit a higher non-union rate, they should be treated surgically in the event of displacement or sub-acromial space reduction, in order to achieve good functional recovery.
肩峰骨折是一种不常见的损伤，常常诊断较晚。虽然通常采用保守治疗，但这些骨折的手术指征非常明确。一名52岁的活跃男性因右肩部受伤前来我院门诊就诊。X线检查显示为II型肩峰基底部轻度移位骨折。最初尝试保守治疗，但六周后发现骨折未愈合且进展为移位的III型骨折，遂转为手术固定。术后恢复顺利，右肩部功能逐渐恢复至伤前水平，通过Constant评分以及加州大学洛杉矶分校（UCLA）肩部评分进行评估。最终功能结局的满意度通过UCLA肩部评分进行评估。临床医生必须积极排查所有肩部损伤中的肩峰骨折。轻度移位骨折应定期随访，观察有无移位及肩峰下间隙变窄。虽然肩峰骨折通常采用保守治疗，尽管不愈合率较高，但如果发生移位或肩峰下间隙变窄，则应进行手术治疗，以实现良好的功能恢复。
