Bilateral acromial stress fractures in a patient with a massive rotator cuff tear

Kim, Du Hwan; Na, Sang-Soo; Baek, Chung-Sin; Cho, Chul-Hyun

doi:10.5397/cise.2020.00080

Cited by 3 publications

(2 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Three studies were excluded as the specific treatment for acromial/scapular spine fracture was not mentioned [ 21 , 22 , 23 ]. Three studies did not report on acromial/scapular spine fracture in the context of RSA, one study was not in German or English language, and one study did not report on specific outcomes after treatment of acromial/scapular spine fracture [ 24 , 25 , 26 , 27 , 28 ]. One study was identified from review references of the identified articles [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

Acromial and Scapular Spine Fractures following Reverse Total Shoulder Arthroplasty—A Systematic Review of Fixation Constructs and Techniques

Cassidy¹,

Paszicsnyek

Ernstbrunner

et al. 2022

JCM

View full text Add to dashboard Cite

Fractures of the acromion and the scapular spine are established complications of reverse shoulder arthroplasty (RSA), and when they occur, the continuous strain by the deltoid along the bony fragments makes healing difficult. Evidence on treatment specific outcomes is poor, making the definition of a gold standard fixation technique difficult. The purpose of this systematic review is to assess whether any particular fixation construct offers improved clinical and/or radiographic outcomes. A systematic review of the literature on fixation of acromial and scapular spine fractures following RSA was carried out based on the guidelines of PRISMA. The search was conducted on PubMed, Embase, OVID Medline, and CENTRAL databases with strict inclusion and exclusion criteria applied. Methodological quality assessment of each included study was done using the modified Coleman methodology score to asses MQOE. Selection of the studies, data extraction and methodological quality assessment was carried out by two of the authors independently. Only clinical studies reporting on fixation of the aforementioned fractures were considered. Fixation construct, fracture union and time to union, shoulder function and complications were investigated. Nine studies reported on fixation strategies for acromial and scapular spine fractures and were therefore included. The 18 reported results related to fractures in 17 patients; 1 was classified as a Levy Type I fracture, 10 as a Levy Type II fracture and the remaining 7 fractures were defined as Levy Type III. The most frequent fixation construct in type II scapular spine fractures was a single plate (used in 6 of the 10 cases), whereas dual platin was the most used fixation for Levy Type III fractures (5 out of 7). Radiographic union was reported in 15 out of 18 fractures, whereas 1 patient (6.7%) had a confirmed non-union of a Levy Type III scapular spine fracture, requiring revision fixation. There were 5 complications reported, with 2 patients undergoing removal of metal and 1 patient undergoing revision fixation. The Subjective Shoulder Value and Visual Analogue Scale pain score averaged 75% and 2.6 points, respectively. The absolute Constant Score and the ASES score averaged 48.2 and 78.3 points, respectively. With the available data, it is not possible to define a gold standard surgical fixation but it seems that even when fracture union can be achieved, functional outcomes are moderate and there is an increased complication rate. Future studies are required to establish a gold standard fixation technique.

show abstract

Section: Resultsmentioning

confidence: 99%

Acromial and Scapular Spine Fractures following Reverse Total Shoulder Arthroplasty—A Systematic Review of Fixation Constructs and Techniques

Cassidy¹,

Paszicsnyek

Ernstbrunner

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…A considerable proportion of patients (65.7%) with rotator cuff tears had SD. Although the cause‐and‐effect relationship between SD and shoulder pathologies remains uncertain, and SD may have had variable etiologies [17, 27], the increased risk of external and internal impingements by SD may create a condition wherein rotator cuff tears can easily develop [6, 32]. As previously reported [16], the mean increases in UR, anterior tilt, and IR were also found in this study compared with the intact contralateral scapula in patients with rotator cuff tears.…”

Section: Discussionmentioning

confidence: 99%

Improvement in scapular dyskinesis after rotator cuff repair and subacromial decompression

Song

Yoon

et al. 2021

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

PurposeTo investigate the incidence of scapular dyskinesis (SD) in patients with rotator cuff tears using pre‐ and postoperative 3D computed tomography, analyze the changes in scapular kinematics that occur after arthroscopic rotator cuff repair, and identify the contributing clinical factors. MethodsThirty‐five patients (mean age, 62.5 ± 8.4 years) were included. Four scapular angles (upward rotation, internal rotation, protraction, and posterior tilt) were measured. The patients were categorized into three pre‐existing SD types according to the difference in measured scapular angles between the affected and unaffected sides (type 1 SD, posterior tilt angle difference < − 5°; type 2 SD, internal rotation angle difference > 5°; and type 3 SD, upward rotation angle difference > 5°). The prevalence, factors influencing SD, and outcomes were compared between the improved and sustained SD groups. ResultsTwenty three of the 35 patients (65.7%) with rotator cuff tears had SD (type 1, 11; type 2, six; type 3, six). Of the 23 preoperative SD patients, 12 (52.1%) showed improved SD postoperatively. Most of the patients with improved SD (9/12) had type 1 SD (p = 0.021) and a significantly improved posterior tilt angle (p = 0.043). The improvement in SD was correlated with a higher range of motion of forward flexion and higher Constant scores (all p < 0.05). No healing failure occurred in the improved SD group (p = 0.037). ConclusionThe prevalence of SD was high in patients with degenerative rotator cuff tears. More than half of the SD cases, especially type 1 SD, improved postoperatively. SD recovery correlated with better function and successful rotator cuff healing. Level of evidenceIV.

show abstract

Morphology properties of scapular spine relative to reverse shoulder arthroplasty: A biomechanical study

Chen

Liu

et al. 2023

Biomedical Signal Processing and Control

View full text Add to dashboard Cite

Bilateral acromial stress fractures in a patient with a massive rotator cuff tear

Cited by 3 publications

References 9 publications

Acromial and Scapular Spine Fractures following Reverse Total Shoulder Arthroplasty—A Systematic Review of Fixation Constructs and Techniques

Acromial and Scapular Spine Fractures following Reverse Total Shoulder Arthroplasty—A Systematic Review of Fixation Constructs and Techniques

Improvement in scapular dyskinesis after rotator cuff repair and subacromial decompression

Morphology properties of scapular spine relative to reverse shoulder arthroplasty: A biomechanical study

Contact Info

Product

Resources

About