Fratura do acrômio associada a lesão arterial: relato de caso

Abstract

A fratura do acrômio com lesão arterial é uma associação rara. O quadro clínico caracteriza-se por dor no ombro, incapacidade funcional e edema do membro acometido, com pulso e temperatura distais diminuídos. A radiografia do ombro e a arteriografia definem o diagnóstico e auxiliam na evolução pós-operatória. Os autores relatam um caso raro de fratura da base do acrômio associada a lesão da artéria ulnar ipsilateral, seu tratamento, bem como a avaliação pré e pós-operatória.

Acromion fracture and lateral angle of the scapula spine: Case report and literature review

“…Anatomically, the scapula located at the posterosuperior border of the thorax and attached by several muscles to the gradil arcs, plays an important role in the biomechanics of the upper limb [3]. On its posterior face we have the scapula spine, which can be easily palpated, which ends in an apophysis, acromion, on the inner edge of which there is a joint facet for the clavicle [3,8].…”

“…The fracture of the scapula presents an index of 0.5–1% of all fractures of the body, and therefore are considered uncommon [1,7,[12], [13], [14]] and this can be explained by its great mobility and protection by several layers muscle cells [1,3,12]. Among these, the fracture of the acromion and the spine of the scapula represent 7% and 6%, respectively [13,15].…”

“…The "axillary profile" radiographic evaluation is the main incidence to be performed to diagnose fractures in these locations. Computed tomography is a more detailed imaging exam, therefore, essential to verify such bone lesions, and when performed with three-dimensional reconstruction, identification becomes even easier [3,17]. In the studies by Hil et al [18] and Cicekli et al [16], radiographic and computed tomography examinations also confirmed the fracture of the acromion and made it possible to classify them.…”

“…Fractures in the scapula are considered uncommon in traumatology, representing 3%–5% of the fractures in the shoulder region [1,2], the most common ones occur in the body, neck, glenoid and acromion, respectively [[2], [3], [4], [5]]. The fracture of the spine of the scapula, especially in its lateral angle, is rare, and often, this anatomical location is confused with the acromion itself, although the latter is defined from its anterior portion to the acromial [6].…”

“…In addition, the association between acromial fracture and the lateral angle of the spine of the scapula has its frequency unknown and presents as probable mechanism the direct trauma of high energy in the upper region of the shoulder [2,3,7,8]. The article was to report the case of an association of fracture of acromion and lateral angle of the spine, as well as treatment and review of the literature.…”