Abstract
We retrospectively reviewed the results of 21 patients (22 shoulders) who had surgery for os acromiale.
The mean age of the 6 men and 15 women was 52 years. The dominant side was involved in 10 patients. The duration of symptoms ranged from one month to 13 years. Ten patients had a history of recent trauma. All presented with tenderness over the site of the os and signs of impingement. In three patients, signs of weakness suggested a rotator cuff tear, and three patients had tenderness over the acromioclavicular joint. Rotator cuff tears, four partial and eight full thickness, were present in 12 cases.
Surgery included excision of the os in nine cases and fixation in 13. Ancillary procedures included acro-mioclavicular joint excision (eight), rotator cuff repair (eight), cuff debridement (three) and biceps tenodesis (one).
At follow-up, which ranged from 5 months to 6 years, Constant and American Shoulder and Elbow Surgeons’ scores were assessed. The presence of a deltoid defect was noted and deltoid strength was measured. The mean Constant score at follow-up was 77. Deltoid strength was notably reduced in abduction but not in forward flexion. There were no cases of sepsis. Five cases required further surgery. In three, this involved removal of metal, but persistent pain necessitated one subsequent rotator cuff repair and one arthroscopic debridement of the subacromial space.
The outcome of both fixation and excision was satisfactory, but the reoperation rate was higher in patients who underwent fixation. We advise arthroscopic excision of meso-acromion in the absence of a full thickness rotator cuff tear.
The abstracts were edited by Prof. M.B.E. Sweet. Correspondence should be addressed to him at the Department of Orthopaedic Surgery, Medical School, University of the Witwatersrand, 7 York Road, Parktown, 2193 South Africa
