Case Reports

Arthroscopically-Guided, Cannulated, Headless Compression Screw Fixation of the Symptomatic Os Acromiale

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  • Os acromiale is a failure of acromial ossification centers to fuse, and occurs in 8% of the population.
  • Symptomatic os acromiale can be treated with repair, or sometimes excision or acromioplasty.
  • Repair preserves the anterior deltoid origin and can result in less pain than excision of the fragment.
  • Repair of larger fragments can be completed with cannulated screws to reliably achieve union.
  • The arthroscope-assisted repair technique described in this article preserves vascularity and can reduce the risk of hardware-related complaints.




Os acromiale is a failure of fusion between 1 or more ossification centers of the scapula and the acromion process. Pain can be caused by motion and impingement of the unfused segment. Several methods for the management of os acromiale have been described. Internal fixation is the most common surgical technique, followed by excision and acromioplasty. We present a novel technique for treatment of symptomatic os acromiale using arthroscopically-guided headless compression screws. This is a viable technique in the management of symptomatic os acromiale due to preservation of the periosteal blood supply and less concern for symptomatic hardware.

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