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synonyms: acromion fracture, acromion fx, broken shoulder, acromial process fracture, acromial fracture
Acromion Fracture ICD-10
- S42.121A - Displaced fracture of acromial process, right shoulder, initial encounter for closed fracture
- S42.122A - Displaced fracture of acromial process, left shoulder, initial encounter for closed fracture
- S42.123A - Displaced fracture of acromial process, unspecified shoulder, initial encounter for closed fracture
- S42.124A - Nondisplaced fracture of acromial process, right shoulder, initial encounter for closed fracture
- S42.125A - Nondisplaced fracture of acromial process, left shoulder, initial encounter for closed fracture
- S42.126A - Nondisplaced fracture of acromial process, unspecified shoulder, initial encounter for closed fracture
Acromion Fracture ICD-9
- 811.01 (closed fracture of acromial process of scapula)
- 811.11 (open fracture of acromial process of scapula)
Acromion Fracture Etiology / Epidemiology / Natural History
- Uncommon: may occur from fall directly onto shoulder such as fall from bike, or in contact sports such as rugby, football, hockey.
- May occur following reverse total shoulder arthroplasty.
Acromion Fracture Anatomy
- Acromial apophysis develops from 4 separate ossification centers: basiacromion, meta-acromion, mesoacromion, and preacromion.
- Complete union of all centers may not occur until age 25.
Acromion Fracture Clinical Evaluation
- Pain in shoulder with tenderess, possible deformity over the acromion.
Acromion Fracture Xray / Diagnositc Tests
- Shoulder series. May consider CT scan for further evaulation of fracture displacement and configuration.
Acromion Fracture Classification / Treatment
- Type I=non displaced. Avulsion fx(type IA), non displaced fx (IB). Treatment = nonoperative.
- Type II=displaced, but does not cause a reduction in the subacromial space. Treatment = nonoperative.
- Type III=displaced causeing reduction in subacromial space either by inferior displacement or by being associated with an ipsilateral superiorly displaced glenoid neck fx. Treatment = ORIF
Acromion Fracture Associated Injuries / Differential Diagnosis
Acromion Fracture Complications
Acromion Fracture Follow-up Care
- Post-op: sling for comfort, no overhead motion. Immediate pendelum ROM exercises.
- 10-14 Days: Wound check, sutures removed. Start PT for gentle ROM exercises. No resistive exercises/activities. Continue sling.
- 6 weeks: Xrays, if union is evident begin strengthening and resistive exercises. No contact athletics.
- 3 months: Repeat xrays. If no signs of union, consider bone stimulator, see Nonunion.
- Return to sport: there shoulde be both clinical and radiographic evidence of union. Fracture site should be nontender, full shoulder ROM achieved and strength comparable to contralateral side. Generally avoid contact sports and heaving lifting for 4-6 months.
- Shoulder Outcome measures.
Acromion Fracture Review References
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