• George A Konstantinidis, Troy Smithers, and Thin Foo Hong.
• Orthopaedic Department, Royal Darwin Hospital, 105 Rockland drive, TiWi, Darwin, NT, 0810, Australia. konstantigeo@yahoo.com.
• Arch Orthop Trauma Surg. 2020 Sep 1; 140 (9): 1181-1189.

IntroductionAcromion fractures are rare and difficult to treat. There is no consensus on type of fixation. Due to the rarity of the injury, it is difficult to compare different techniques of osteosynthesis.ObjectivesThe aim of this study was to present the long-term results of an alternative method of plating Ogawa type IIB meta-acromion fractures and to review the literature.DesignRetrospective study.Materials And MethodsWe present a case series of 11 consecutive patients with displaced Ogawa type IIB meta-acromion fracture, treated with open reduction internal fixation using a 3.5-mm contoured pelvic reconstruction plate with a 90° twist. Patients' mean age was 53.3 years (23-80 years) and the mean follow-up was 48.3 months (15 months-9 years). The outcomes related to pain and shoulder function were evaluated by Modified American Shoulder and Elbow Surgeons Score (ASES) and SF-36 score. All patients were asked about their satisfaction level.ResultsNine out of eleven patients were included in this study. Eight of them obtained union and all were satisfied with the final outcome. The mean ASES and SF-36 score were 69.75 (42.4-98.14) and 61.37 (41.64-94.99), respectively, with poor scores to be largely associated with comorbidities and concomitant injuries.ConclusionsThe use of 3.5-mm reconstruction plate with a 90° twist for open reduction internal fixation (ORIF) of meta-acromion fractures presents satisfactory results and could be technically a more stable biomechanical construct in comparison to the existing surgical techniques.

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