Os akromiale: Omuz sıkışma sendromunun nadir bir nedeni
Os akromiale, omuz sıkışma sendromunun nadir nedenlerinden biridir. Akromionun sekonder ossifikasyon merkezinin füzyonundaki yetersizlik olarak tanımlanmıştır. Burada, semptomatik os akromiale nedeniyle, kanüllü vida ve gergi bandı ile greftleme yapılarak tedavi edilen 35 yaşında kadın hasta sunuldu. Hem klinik hem de radyolojik olarak çok iyi sonuç elde edildi. Omuz sıkışma sendromunun tanısında os akromialenin de düşünülmesi gerektiği ve kanüllü vida, gergi bandı ve greftlemenin, büyük fragmanların tedavisinde iyi bir seçenek olduğu kanaatindeyiz.
Os acromiale: A rare cause of shoulder impingement syndrome
Os acromiale is a rare cause of impingement syndrome. It is described as a failure of fusion of the secondary centers of ossification of the acromion. A thirty-five-year-old female patient with symptomatic os acromiale is presented. She was treated with a cannulated screw combined with tension band and bone grafting. Excellent results were obtained both clinically and radiologically. Os acromiale should be considered in the diagnosis of impingement syndrome and placement of a cannulated screw combined with tension band and bone grafting seems to yield better results in the treatment of larger fragments.
___
- 1.Mudge MK, Wood VE, Frykman GK. Rotator cuff tears associated with os acromiale. J Bone Joint Surg [Am] 1984; 66:427-9.
- 2.Edelson JG, Zuckerman J, Hershkovitz I. Os acromiale: anatomy and surgical implications. J Bone Joint Surg [Br] 1993; 75:551-5.
- 3.Norris TR, Fischer J, Bigliani LU, Neer CS II. The unfused acromial epiphysis and its relationship to impingement syndrome. Orthop Trans 1983;7:505-6.
- 4.Sher JS. Anatomy, biomechanics and pathophysiology of rotator cuff disease. In: Iannotti JP, Williams GR, editors. Disorders of the shoulder: diagnosis and management. 1st ed. Philadelphia: Lippincott Williams&Wilkins; 1999. p. 3-29.
- 5.Liberson F. Os acromiale- a contested anomaly . J Bone Joint Surg 1937;19:683-9.
- 6.Nicholson GP, Goodman DA, Flatow EL, Bigliani LU. The acromion: morphologic condition and age-related changes. A study of 420 scapulas. J Shoulder Elbow Surg 1996;5:1-11.
- 7.Burkhart SS. Os acromiale in a professional tennis player. Am J Sports Med 1992;20:483-4.
- 8.Jobe MC. Gross anatomy of the shoulder. In: Rockwood CA, Matsen FA, editors. The shoulder. 2nd ed. Philadelphia: WB Saunders Comp.; 1998. p. 34-97.
- 9.Swain RA, Wilson FD, Harsha DM. The os acromiale: another cause of impingement. Med Sci Sports Exerc 1996; 28:1459-62.
- 10.Akpınar S, Demirhan M, Akman fi, Atalar AC. Os acromiale: Anatomi ve cerrahi indikasyonlar (olgu sunumu ve derleme). Acta Orthop Traumatol Turc 1998;32:69-72.
- 11.Hutchinson MR, Veenstra MA. Arthroscopic decompression of shoulder impingement secondary to Os acromiale. Arthroscopy 1993;9:28-32.
- 12.Sterling JC, Meyers MC, Chesshir W, Calvo RD. Os acromiale in a baseball catcher. Med Sci Sports Exerc 1995; 27:795-9.
- 13.Post M. The shoulder: surgical and nonsurgical management. 2nd ed. Philadelphia: Lea & Febiger; 1988. p. 373-4.
- 14.Remiger AR, Forster T, Buschor F, Blatter G, Gachter A. How to fuse an unstable os acromiale. 13th Congress of ESSSE; 1999 Sep 8-11; The Hague-Netherlands. Abstract Book. 1999. p. 262.
- 15.Warner JJ, Beim GM, Higgins L. The treatment of symptomatic os acromiale. J Bone Joint Surg [Am] 1998;80:1320-6.
- 16.Akpınar S, Güven O, Demirhan M, Atalar AC, Karahan M. Os acromiale (a rare cause of impingement syndrome). 13th Congress of ESSSE; 1999 Sep 8-11; The Hague- Netherlands. Abstract Book. 1999. p. 261.
- 17.Bigliani LU, Barrallet JA, Brittis D, Self EB, Flatow EL. The surgical treatment of an unfused acromial epiphysis in association with a tear of the rotator cuff: a review of 41 cases. J Shoulder Elbow Surg 1993;2:24.
- 18. Neer CS II. Shoulder reconstruction. 1st ed. Philadelphia: WB Saunders Comp.; 1990.