os acromiale rupture associated with a massive rotator cuff tear causing deltoid insufficiency and...

Os Acromiale Rupture Associated with a Massive Rotator Cuff Tear Causing Deltoid Insufficiency and Superior

Escape of the Humeral Head

by Gregory J. Pinkowsky, and April D. Armstrong

JBJS Case ConnectVolume 4(1):e17

February 12, 2014

©2014 by The Journal of Bone and Joint Surgery, Inc.

Gregory J. Pinkowsky, and April D. Armstrong JBJS Case Connect 2014;4:e17


This clinical photograph of the defect along the anterior aspect of the shoulder (arrow) at the origin of the deltoid muscle was taken while the patient was attempting shoulder abduction.



Coronal T2-weighted fat-suppressed MRI (left) indicates a full-thickness rotator cuff tear with substantial retraction; a large effusion is present.



The posterolateral view shows that the suture was placed through the os acromiale fragment with the attached deltoid muscle fibers.



The os acromiale fragment is outlined in yellow, the attached deltoid muscle fibers are outlined in black, and the lateral aspect of the acromioclavicular joint is outlined in white.



Intraoperative photograph taken from the superior view.



The intact posterior part of the acromion is outlined in black, and the displaced os acromiale piece is outlined in gray.



Final clinical photographs revealing full forward elevation and approximately 130° of shoulder abduction.



os acromiale rupture associated with a massive rotator cuff tear causing deltoid insufficiency and...

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