[The shape of the acromion and its effect on the subacromial space].

Abstract

PURPOSE OF THE STUDY A great variability of the shape of acromion exists in the population. The shape of the acromion plays a great role in development of the pathology of the subacromial space. Quantification of the anatomical changes using radiological examination (X-ray. CT) is a major contribution to the diagnosis of the subacromial space disorders and to differential diagnosis of painful affections of the shoulder. The aim of the study was to assess the prevalence of the degenerative changes in the subacromial space and their relation to the shape of the inferior space of acromion in our population. MATERIAL AND METHODS In 50 randomly chosen cadavers during autopsy both shoulders where surgically explored in order to evaluate the changes on the rotator cuff and the changes on the major tubercule, on the tendon of the long head of biceps brachii in correlation to the shape of the inferior surface of acromion. RESULTS Rotator cuff lesions of variable size were found in 16 cadavers, in 10 cases the lesion was unilateral, in 6 cases bilateral. The lesions were more often seen in the older age group. With increasing concavity of the inferior surface of acromion not only the number of the rotator cuff lesions and degenerative changes in the subacromial space were increasing, but so was the amount of the changes. CONCLUSION The shape of acromion and increasing concavity plays a major role in the development of the subacromial pathology, accelerate the degenerative changes in this space. Reshaping the undersurface of acromion and diminishing the concavity in first stages of clinical symptoms, which present mostly as impingement syndrome, is reasonable to prevent larger pathological deterioration in subacromial space. The authors conclude that according to the relation between the shape of the inferior surface of acromion and the amount of lesion an early operative procedure is valuable.