Abstract
The procedures for and results of the osteotomy of the acromion accompanying the operation of massive cuff tears were analyzes.
Sixteen osteotomies of the acromion were studied among which,9 were accompanied by a Dubeyre procedure and 7 by a trapezius transfer.
13 right shoulders were involved and 3 cases were left.
There were 15 males and 1 female with an average age of 61 years old.
The methods of osteotomy were divided into 4 groups.
(1),1 osteotomy at the middle of the acromion parallel to the scapular plane (F1).
(2), (1) plus 1 osteotomy perpendicular to the scapular plane (F1S1).
(3),1 osteotomy perpendicular to the scapular plane (S1).
(4),2 osteotomies perpendicular to the scapular plane (S2).
All the osteotomies were reduced and fixed by Kirschner wires.
The tension band wiring technique was performed in 7 cases.
Nine cases of F1 osteotomy resulted in 7 bony unions,1 non-union and 1 unknown. The average periods for union were 3.1 months in thie Debeyre group and 13.7 months in the trapezius transfer group.
Three cases of F1S1 osteotomy resulted in I bony union and 2 non-unions. The period for union was 4.7 months in the trapezius transfer group.
One case of S1 osteotomy accompanied by a trapezius transfer resulted in a bony union within 2.6months.
Three cases of S2 osteotomy resulted in 1 bony union,1 delayed union and 1 non-union. The period for union was 18.1 months in the Debeyre procedure group.
The improvement rate evaluated by the Japanese Orthopaedic Association shoulder score was better in the group with bony union of the acromion than in the group with no bony union.
In conclusion, an F1 osteotomy followed by Kirschner wire fixation with the tension band wiring technique seems to be the most reliable method to get a bony union of an osteotomy of the acromion.
