Faculty, Staff and Student Publications

Language

English

Publication Date

11-1-2025

Journal

JSES International

DOI

10.1016/j.jseint.2024.12.016

PMID

41584521

PMCID

PMC12828205

PubMedCentral® Posted Date

8-13-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Acromion and scapular spine fractures (ASFs) pose significant challenges in the management of patients undergoing reverse total shoulder arthroplasty and there is a pressing need for effective preventive measures. Current predictive factors for ASF include female sex, osteoporosis, older age, and anatomical considerations such as glenoid medialization and acromial morphology. However, surgical options to mitigate ASF risk are limited. In this study, we propose a novel technique: incorporation of distal acromial tip fusion (DATF) during primary reverse total shoulder arthroplasty procedures. DATF involves bony fusion between the undersurface of the anterolateral acromion and the region where the superior rim of the glenoid meets the lateral base of the coracoid using a strut graft. The primary objective is to reinforce the anterior acromion process, thereby enhancing shoulder suspensory complex rigidity and theoretically reducing ASF risk. The technique involves precise positioning and exposure, graft preparation, and fixation. While DATF shows promise in ASF prevention, further biomechanical and clinical data are needed to validate its efficacy and safety. Nevertheless, in patients with a high risk of ASF, DATF may offer a viable prophylactic intervention alongside existing management strategies.

Keywords

Shoulder fusion, Navigated reverse shoulder arthroplasty, Computer assisted surgery, Acromion and scapular spine fracture, Osteoporosis, Surgical technique, Prophylactic fixation, Bone graft

Published Open-Access

yes

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.