CASE REPORT Fracture of the acromion associated with arterial lesion: case report Fratura do acrômio associada a lesão arterial: relato de caso

The acromion (AC) is a strong bone that functions as a shield, protecting the structures of the subacromial region. It absorbs and dissipates the forces applied to the shoulder region;1 however, high energy force may produce fractures, as well as other severe lesions. Therefore, diagnosis may not be immediately performed due to the necessity of assessing associated lesions.2 Acromion fracture is rare and accounts for only 9% of scapular fractures, which correspond to 1% of all the fractures.3 It may result from a direct force applied to the upper region of the AC, or a deviation or superior dislocation of the humeral head, which may also bring about a severe disruption of the rotator cuff.4 Fractures frequently present a minimal deviation and do not require surgical treatment. It is important to distinguish them from the os acromiale,1-3 which is the failure of the AC’s ossification centers’ fusion. In the case of a deviated fracture, association with brachial plexus lesion should be considered.5 Most AC fractures are concomitant with fractures of the caracoid,6 clavicule,7 scapular neck or body,8 acromioclavicular dislocation9 or glenohumeral dislocation,3 but the neurovascular exam in high-magnitude trauma is always important. This case report discusses a fracture of the AC’s basis associated with ipsilateral ulnar artery lesion, its treatment and evolution, drawing attention to possible associations between these two lesions. The study was approved by the Research Ethics Committee of Hospital Geral de Goiânia.