1/23/2024 0 Comments Distal clavicle fracture![]() ![]() The clavicle hook plate is a widely used technique for both distal clavicle fractures and AC joint dislocation, and it yields satisfactory clinical outcomes, despite lacking a gold standard. Therefore, os acromiale can affect treatment determination of distal clavicle fractures or AC joint dislocation, leading to different outcomes and complications. Previous literature has reported that transacromial erosion was caused by a subacromial hook plate in the treatment of AC joint dislocation, requiring the removal of the hook plate and suture reconstruction of the AC joint. Specifically, surgical intervention is required if os acromiale is complicated with ipsilateral shoulder injuries, such as distal clavicle fractures or acromioclavicular (AC) joint dislocation. Surgical interventions, including open fragment excision or arthroscopic decompression, can be used if conservative treatments fail. Regarding symptomatic os acromiale, conservative treatments, such as physical therapy and subacromial corticosteroid injections, are commonly recommended. Os acromiale can be potentially missed or misdiagnosed as acromion fracture, so therefore, two correct and clear views (anteroposterior and axillary views) are required to facilitate correct diagnosis. Despite the reported symptom of shoulder pain, most of os acromiale is asymptomatic and discovered accidentally. Os acromiale represents one or more unfused ossification centers of the acromion, and its frequency is documented in a range of 1–15 %. An axillary lateral radiograph is recommended to detect potential os acromiale in patients using a hook plate. Ipsilateral os acromiale may be a relative contraindication to the clavicle hook plate. Both yielded satisfactory outcomes and voided 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. Following a comprehensive evaluation, os acromiale may limit the application of a clavicle hook plate due to potential transacromial erosion. ![]() Both patients were diagnosed with os acromiale with CT or MRI and acute distal clavicle fracture or acromioclavicular joint dislocation. Case presentationĪ 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. 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. 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.
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