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Wheeless' Textbook of Orthopaedics
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Os Acromiale


- Discussion:
    - results from failure of an anterior acromial ossification center to fuse to the acromial process;
    - caused by failure of one of three ossification centers;
            - ossification centers appear at age 15 and should fuse by age 22-25;
    - subtypes: preacromion, mesacromion, metacromion, and basiacromion types;
            - mesacromion and metacromion are most common;
    - patients may show impingement like symptoms but will also have localized tenderness;
    - strong association with rotator cuff tear;
    - references:
            - Rotator cuff tears associated with os acromiale.   MK Mudge et al. Vol 66-A. 1984. p 427-429.
            - Rotator cuff tears associated with os acromiale.
            - Os acromiale: frequency, anatomy, and clinical implications.


- Radiographs:
    - may be seen axillary or Stryker notch views;
    - references:
          - The double-density sign: a radiographic finding suggestive of an os acromiale.


- Treatment:
    - references:
          - Os acromiale: anatomy and surgical implications.
          - Os acromiale associated with tear of the rotator cuff treated operatively. Review of 33 patients.
          - Surgical management of the symptomatic os acromiale.
          - Arthroscopic decompression of shoulder impingement secondary to os acromiale. MR Hutchinson and MA Veenstra. Arthroscopy Vol 9. 1993. p 28-32.
          - Internal fixation of symptomatic os acromiale: a series of twenty-six cases.











Internal fixation of symptomatic os acromiale: a series of twenty-six cases

The Double-Density Sign: A Radiographic Finding Suggestive of an Os Acromiale.

Os acromiale: evaluation and treatment.

Surgical treatment of os acromiale with and without associated rotator cuff tears.

Painful os acromiale (or unfused acromial apophysis) in athletes.













Original Text by Clifford R. Wheeless, III, MD.