Arthroscopic treatment of isolated fracture of the posterolateral angle of the acromion.

Abstract

Isolated fractures of the acromion are rare. Fracture avulsion of the posterolateral part of the acromion is even more rare. In 1996, a classification of Types I, II, and III was proposed, along with a recommendation for surgical treatment with open reduction and internal fixation for type III fracture. This report describes arthroscopic treatment provided according to a specialized technique that can be used for displaced avulsion fracture of the posterolateral angle of the acromion with reduction of the posterior subacromial space. This injury occurred in a 43-year-old recreational cyclist who injured his right shoulder through a direct blow. The fracture was exposed after the hematoma and the periosteum from the anterolateral portal had been debrided with a motorized shaver. The fracture was reduced by percutaneous pinning, and the position of the fragments was corrected and stabilized with the use of 2 pins--1 anterior and 1 posterior. In the medium part of the lateral fragment, a pin was introduced for implant of the titanium cannulated screw. After 3 weeks, the pins were removed; the screw was taken out after 2 months. Radiographs at 1 year after surgery indicated that bone union had occurred; further physical examination revealed a complete range of motion. The patient was able to return to cycling with no additional problems.