Os acromiale: evaluation and treatment.
Os acromiale is a developmental aberration in which the distal acromion fails to fuse. This aberration is often discovered incidentally but may present with a clinical picture similar to that of subacromial impingement syndrome. Treatment for symptomatic os acromiale is initially nonoperative-activity modification, physical therapy, corticosteroid injection, use of nonsteroidal anti-inflammatory medication. Nonoperative management of clinically significant, radiographically confirmed os acromiale should be pursued for at least 6 months before consideration of surgical intervention. Subacromial decompression is often necessary to address symptoms of impingement. Excision of the os fragment may provide definitive treatment for smaller fragments (<3 cm). Removal of larger fragments remains controversial and should be approached with caution. Surgical fixation of larger fragments with or without supplemental autograft in conjunction with a structured postoperative program of physical therapy can reliably provide relief for symptomatic os acromiale.
Youm
Thomas
T
Department of Orthopaedic Surgery, New York University-Hospital for Joint Diseases, New York, New York, USA. youmt01@yahoo.com
Hommen
Jan Pieter
JP
Ong
Bernard C
BC
Chen
Andrew L
AL
Shin
Catherine
C
D000174:Acromion / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D019299:Decompression, Surgical; D006801:Humans; D019637:Orthopedic Procedures; D010808:Physical Examination; D011859:Radiography; D016059:Range of Motion, Articular; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis; D012785:Shoulder Joint / Q000503:physiopathology; D020069:Shoulder Pain / Q000209:etiology