Abstract
BackgroundOs acromiale can be potentially missed or misdiagnosed as acromion fracture, and this can affect treatment determination if it is complicated with an ipsilateral shoulder injury. The clavicle hook plate is a widely used technique for distal clavicle injuries, leading to transacromial erosion, particularly when in the presence of os acromiale.Case presentationA 70-year-old man and a 78-year-old man who had limited mobility and severe pain in their right shoulders following falls attended the emergency center. Both patients were diagnosed with os acromiale with CT or MRI and acute distal clavicle fracture or acromioclavicular joint dislocation. Following a comprehensive evaluation, os acromiale may limit the application of a clavicle hook plate due to potential transacromial erosion. The distal clavicle fracture with ipsilateral os acromiale received treatment with a volar radius locking T plate, and the acromioclavicular joint dislocation with ipsilateral os acromiale was reconstructed using suture anchors. Both yielded satisfactory outcomes and voided transacromial erosion.ConclusionsIpsilateral os acromiale may be a relative contraindication to the clavicle hook plate. An axillary lateral radiograph is recommended to detect potential os acromiale in patients using a hook plate.
Highlights
Os acromiale can be potentially missed or misdiagnosed as acromion fracture, and this can affect treatment determination if it is complicated with an ipsilateral shoulder injury
Ipsilateral os acromiale may be a relative contraindication to the clavicle hook plate
Previous literature has demonstrated that the most common type of os acromiale is the unfused center between the meso-acromion (MSA) and meta-acromion (MTA) (Fig. 1A), where the coronal cleft is right at the posterior margin of the AC joint [11] and above the hook of the clavicle hook plate
Summary
Ipsilateral os acromiale may be a relative contraindication to the clavicle hook plate.
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