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Os Acromionale Classification

 

  1. Preacromion
  2. Preacromionale: (uncommon) Initial treatment is rest, RTC and periscapular muscle strengthening, ice, modalities, NSAIDS, subacromial injection. Consider corticosteriod injection at the nonunion site. Consider arthroscopic subacromial decompression with fragment excision for very small fragments vs ORIF/bone graft for larger fragments. Arthroscopic excision is done to the superior cortical plate, leaving the deltoid intact. (Wright RW, Arthroscopy 2000;16:595)
  3. Mesoacromion
  4. Mesoacromionale: (most common) Initial treatment is rest, RTC and periscapular muscle strengthening, ice, modalities, NSAIDS, subacromial injection. Consider corticosteriod injection at the nonunion site. ORIF/bone grafting indicated if non-operative managment fails. Fixation utilizing cannulated screws (Acutrak, Herbert, 4.5mm AO) with/without tension bands placed through the cannulated holes provides improved fixation compared to k-wires. (Warner JBJS 1998;80A:1320)
  5. Meta-acromion
  6. Meta-acromionale:(rare) Initial treatment is rest, RTC and periscapular muscle strengthening, ice, modalities, NSAIDS, subacromial injection. Consider corticosteriod injection at the nonunion site. ORIF/bone graft indicated if non-operative managment fails.
  7. Basiacromion
  8. Distal Clavicle
  9. Coracoid Process