Abstract
AbstractSubacromial decompression is one of the most frequently performed procedures in the setting of arthroscopic shoulder surgery and typically includes acromioplasty. However, the indication for acromioplasty remains a subject of debate. Possible complications involve deltoid muscle insufficiency due to an excessive removal of the anterior acromion. This case report is intended to draw attention to this particular complication and its management.
Highlights
A 51-year-old right-hand-dominant female patient presented to our outpatient department with left shoulder impairment
During the previous 7 years she underwent a total of five arthroscopic shoulder surgeries including rotator cuff reconstruction and anterior acromioplasty in another clinic
Active range of motion was reduced when compared with the contralateral shoulder, at 70° of anterior elevation and abduction and 40° of external rotation
Summary
In 1972 Charles Neer pioneered the term “impingement syndrome” as he was convinced that rotator cuff ruptures were caused by a conflict between the rotator cuff tendons and the acromial arch [15]. We used cannulated screws and steel wire cerclages to perform reduction and internal fixation of an iliac crest tricortical bone autograft to the anterior acromion and sutured the deltoid muscle tendon to the bone graft—a technique that has been described by Forsythe et al [5]. Another described technique by Agneskirchner et al [1] was the reconstruction of the coracoacromial arch with an iliac crest bone graft attached to a 10-hole reconstruction plate, which was fixated to the scapular spine and to the coracoid with screws.
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