Kuhn J E, Blasier R B, Carpenter J E
Section of Orthopaedic Surgery, University of Michigan Medical Center, Ann Arbor.
J Orthop Trauma. 1994;8(1):6-13. doi: 10.1097/00005131-199402000-00002.
A review of 27 fractures of the acromion process during a 15-year period revealed five distinct types that were classified into three groups. Stress fractures are rare, do not result from acute trauma, and gain little benefit from nonoperative treatment. Type I fractures are minimally displaced. Type IA fractures are avulsion fractures and heal rapidly. Type IB fractures result from direct trauma to the extremity, and are minimally displaced. Most heal with nonoperative treatment. Type II fractures are displaced laterally, superiorly or anteriorly and do not reduce the subacromial space. Most are pain free with full motion after 6 weeks of nonoperative treatment. Type III fractures reduce the subacromial space. This may occur by an inferiorly displaced acromion fracture, or an acromion fracture associated with an ipsilateral, superiorly displaced glenoid neck fracture. Patients in this group sustained significant trauma to the involved extremity. All type III fractures treated nonoperatively develop significant limited shoulder motion with pain, suggesting that early surgical intervention may be indicated.
对15年间27例肩峰骨折的回顾显示，有五种不同类型，分为三组。应力性骨折罕见，并非由急性创伤引起，非手术治疗获益甚微。I型骨折移位极小。IA型骨折为撕脱性骨折，愈合迅速。IB型骨折由肢体直接创伤导致，移位极小。多数经非手术治疗可愈合。II型骨折向外侧、上方或前方移位，未使肩峰下间隙减小。多数经6周非手术治疗后可全活动且无痛。III型骨折使肩峰下间隙减小。这可能由肩峰骨折向下移位，或肩峰骨折合并同侧肩胛盂颈骨折向上移位所致。该组患者受伤肢体遭受严重创伤。所有非手术治疗的III型骨折均出现明显的肩部活动受限伴疼痛，提示可能需要早期手术干预。
