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Nonunion of the so-called acromion: a systematic review with consideration of the terminology

INTRODUCTION: There is no widely accepted standard for the classification and treatment of traumatic acromion/scapular spine fracture nonunion due to the scarcity of this condition and the confusion of terminology. MATERIALS AND METHODS: PubMed and Scopus were searched using “scapular fracture” and...

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Autores principales: Ogawa, Kiyohisa, Matsumura, Noboru, Yoshida, Atsushi, Inokuchi, Wataru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10449677/
https://www.ncbi.nlm.nih.gov/pubmed/37314525
http://dx.doi.org/10.1007/s00402-023-04912-z
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author Ogawa, Kiyohisa
Matsumura, Noboru
Yoshida, Atsushi
Inokuchi, Wataru
author_facet Ogawa, Kiyohisa
Matsumura, Noboru
Yoshida, Atsushi
Inokuchi, Wataru
author_sort Ogawa, Kiyohisa
collection PubMed
description INTRODUCTION: There is no widely accepted standard for the classification and treatment of traumatic acromion/scapular spine fracture nonunion due to the scarcity of this condition and the confusion of terminology. MATERIALS AND METHODS: PubMed and Scopus were searched using “scapular fracture” and “acromion fracture” or “scapular spine fracture” as search terms. The inclusion criteria were English full-text articles concerning acromion/scapular spine fracture nonunion that described patient characteristics and presented appropriate images. The exclusion criteria were cases without appropriate images. Citation tracking was conducted to find additional articles and notable full-text articles written in other languages. Fractures were classified using our newly proposed classification system. RESULTS: Twenty-nine patients (19 men, 10 women) with 29 nonunions were identified. There were four type I, 15 type II, and 10 type III fracture nonunions. Only 11 fractures were isolated. The mean period from initial injury to final diagnosis was 35.2 ± 73.2 months (range 3–360 months) (n = 25). The most frequent cause of delayed diagnosis was conservative treatment for fracture in 11 patients, followed by oversight by the physician in 8. The most common reason for seeking medical advice was shoulder pain. Six patients received conservative therapy, and 23 received operative treatment. Fixation materials included various plates in 15 patients, and tension band wiring in 5. Bone grafting was performed in 16 patients (73%, 16/22). Of the 19 surgically treated patients with adequate follow-up, the outcome was rated excellent in 79%. CONCLUSIONS: Isolated acromion/scapular spine fracture nonunion is rare. Fracture type II and III, arising in the anatomical scapular spine, accounted for 86% of the fractures. Computed tomography is required to prevent fracture oversight. Surgical therapy produces good stable results. However, it is important to select the appropriate surgical fixation method and material after considering the anatomical characteristics of the fracture and stress on the fractured portion. LEVEL OF EVIDENCE: V
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spelling pubmed-104496772023-08-26 Nonunion of the so-called acromion: a systematic review with consideration of the terminology Ogawa, Kiyohisa Matsumura, Noboru Yoshida, Atsushi Inokuchi, Wataru Arch Orthop Trauma Surg Trauma Surgery INTRODUCTION: There is no widely accepted standard for the classification and treatment of traumatic acromion/scapular spine fracture nonunion due to the scarcity of this condition and the confusion of terminology. MATERIALS AND METHODS: PubMed and Scopus were searched using “scapular fracture” and “acromion fracture” or “scapular spine fracture” as search terms. The inclusion criteria were English full-text articles concerning acromion/scapular spine fracture nonunion that described patient characteristics and presented appropriate images. The exclusion criteria were cases without appropriate images. Citation tracking was conducted to find additional articles and notable full-text articles written in other languages. Fractures were classified using our newly proposed classification system. RESULTS: Twenty-nine patients (19 men, 10 women) with 29 nonunions were identified. There were four type I, 15 type II, and 10 type III fracture nonunions. Only 11 fractures were isolated. The mean period from initial injury to final diagnosis was 35.2 ± 73.2 months (range 3–360 months) (n = 25). The most frequent cause of delayed diagnosis was conservative treatment for fracture in 11 patients, followed by oversight by the physician in 8. The most common reason for seeking medical advice was shoulder pain. Six patients received conservative therapy, and 23 received operative treatment. Fixation materials included various plates in 15 patients, and tension band wiring in 5. Bone grafting was performed in 16 patients (73%, 16/22). Of the 19 surgically treated patients with adequate follow-up, the outcome was rated excellent in 79%. CONCLUSIONS: Isolated acromion/scapular spine fracture nonunion is rare. Fracture type II and III, arising in the anatomical scapular spine, accounted for 86% of the fractures. Computed tomography is required to prevent fracture oversight. Surgical therapy produces good stable results. However, it is important to select the appropriate surgical fixation method and material after considering the anatomical characteristics of the fracture and stress on the fractured portion. LEVEL OF EVIDENCE: V Springer Berlin Heidelberg 2023-06-14 2023 /pmc/articles/PMC10449677/ /pubmed/37314525 http://dx.doi.org/10.1007/s00402-023-04912-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Trauma Surgery
Ogawa, Kiyohisa
Matsumura, Noboru
Yoshida, Atsushi
Inokuchi, Wataru
Nonunion of the so-called acromion: a systematic review with consideration of the terminology
title Nonunion of the so-called acromion: a systematic review with consideration of the terminology
title_full Nonunion of the so-called acromion: a systematic review with consideration of the terminology
title_fullStr Nonunion of the so-called acromion: a systematic review with consideration of the terminology
title_full_unstemmed Nonunion of the so-called acromion: a systematic review with consideration of the terminology
title_short Nonunion of the so-called acromion: a systematic review with consideration of the terminology
title_sort nonunion of the so-called acromion: a systematic review with consideration of the terminology
topic Trauma Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10449677/
https://www.ncbi.nlm.nih.gov/pubmed/37314525
http://dx.doi.org/10.1007/s00402-023-04912-z
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