Acromial fracture after reverse shoulder arthroplasty.
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.
Sports and Shoulder/Elbow Center, OrthoCarolina, Charlotte, North Carolina, USA. nady_hamid@hotmail.com
Nady
N
Hamid
Patrick M
PM
Connor
James F
JF
Fleischli
Donald F
DF
D'Alessandro
D000174:Acromion / Q000293:injuries*; D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000009:adverse effects*; D005260:Female; D005592:Fracture Fixation; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D005599:Fractures, Ununited / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*