Background: Stress fractures of the base of the acromion are rare and tend to progress well when conservatively treated. The need for surgery due to this type of fracture has only been reported in two case reports.
Case presentation: A 39-year-old patient, manual laborer, with a stress fracture at the base of the acromion that required surgical treatment due to persistent symptoms and consolidation failure.
Conclusion: We described a new mechanism of injury for stress fractures of the base of the acromion. After the failure of conservative treatment, the patient exhibited good results with osteosynthesis with a plate and screws, with no need for a bone graft.