부산대학교 도서관

Few reports have examined the relationship between the unfused acromial ossification center and shoulder pain. We will report here on two young adults with unstable epiphyseal separation of the acromion associated with motion pain of the shoulder. We also investigated the time courses of the ossification centers of the acromion.(Case 1) A fifteen-year-old girl, without any history of trauma, began to feel motion pain in her left shoulder. An X-ray revealed an unfused acromial ossification center in her left shoulder. Characteristic X-ray findings included widening and irregularity of the epiphyseal line. She complained of tenderness in her left acromion. She also showed a painful arc sign and was positive in the procaine test. Movement of the acromial epiphysis was abnormal. We performed osteosynthesis of the unstable epiphysis using an inlay bone graft and tension band wiring. The pain disappeared postoperatively.(Case 2) A sixteen-year-old girl fell, impacting on her left shoulder,6 months prior to her presentation. X-rays revealed bilateral unfused acromial ossification centers. Characteristic X-ray findings included a widening of and irregularities in the epiphyseal line. She complained of severe tenderness in her left acromion. She did not show a painful arc sign. When we performed osteosynthesis on her left acromion, abnormal movement appeared at the junction between the unfused ossification center and the body of the acromion. The pain disappeared postoperatively.We examined the axial X-ray films of 164 shoulders of 82 individuals. Their a g es ranged from 7 to 25 years. Ossification centers appeared between 10 and 12 years of age and fused between 14 and 20 years of age.(Conclusion) In painful shoulder associated with an epiphyseal separation of the acromion in a young adult, abnormal movement of the unfused ossification center may be a cause of shoulder pain. Osteosynthesis produced complete painrelief. Ossification centers appeared between 10 and 12 years of age and fused between 14 and 20 years of age.