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PubMedDate not supplied

[Development and assessment of so-called rotator cuff ruptures].

The following conclusions can be drawn from our investigations: We could not find out isolated ruptures of the supraspinatus tendon, which were caused exclusively by injury. Mostly ruptures of the rotatory cuff develop spontaneously, the basic degenerative changes involve also the shoulder joint and the acromioclavicular joint. The term rupture of rotatory cuff is misleading, because it signals to the patient the existence of aftermath of injuries and for the most part the rupture is not found in the tendons of the rotatory muscles but in the supraspinatus tendon. The degenerative cuff defects with spontaneous ruptures must be differentiated in medical certificate from the rare rotatory cuff ruptures, which are caused by injury alone. Seldom exogenous mechanical stress may lead to an enlargement of a preexistent rupture with symptoms and clinical signs, which occur for the first time. On the promises, that an adequate injury has occurred, that roentgenographic changes deteriorated within 3 months after the injury and a degenerative defect of rotatory cuff with clinical relevance can be excluded for the time before the injury, the damage of the shoulder has to be accepted by the insurance as an injury after accident. In the most times occasional causes with inadequate injuries to the shoulder are brought up, to assert an old degenerative defect of the shoulder as an aftermath of injury. There are no interrelations between intraoperative findings and mechanism of injury. The anamnestic statement of the patient concerning earlier diseases and injuries are often unreliable.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Occupational↗
PubMedDate not supplied

[Structural findings of the coraco-acromial ligament in rotator cuff rupture, tendinosis calcarea and supraspinatus syndrome].

Coracoacromial ligaments from 133 operation specimens were examined histomorphologically near their acromial attachments. 85% showed signs of moderate to severe degeneration, 67% to 85% chondroid metaplasia near the origin. No significant differences were found between specimens brought to operation for the three diseases mentioned. It is therefore concluded that an intermittent local pressure on the origin of the ligament is present in these diseases, and this can lead to chondroid changes near its acromial attachment.

Acromion↗
PubMedDate not supplied

Suprascapular neuropathy in the differential diagnosis of rotator cuff injuries.

Four cases of suprascapular neuropathy treated by nonoperative means have been presented. Complete recovery occurred in all four. The anatomy of the suprascapular nerve and probable mechanisms of injury secondary to traction have been discussed. The importance of electromyography in diagnosis has been stressed. Longer periods of nonoperative treatment are recommended here than by previous authors. Since the lesion is felt not to be an entrapment phenomenon but, rather, a traction injury, operative treatment should consist of release of the nerve at the notch to reduce the possibility of further traction injury, and a neurolysis should be done as well.

Adolescent↗
PubMedDate not supplied

Aging of the rotator cuff.

The many years of challenge in treating athletes disabled by tendinitis stimulated a study of the aging of tendons. Autopsy specimens, representing tendons from 20-, 50-, and 70-year-old subjects, were obtained. Each specimen, consisting of a wedge of the greater tuberosity with the attached supraspinatus tendon, was examined roentgenographically to study the morphologic features of the greater tuberosity and was decalcified and stained with Safranin O to evaluate the amount of fibro-cartilage, with van Gieson to identify Sharpey's fibers, and with hematoxylin and eosin to determine cellularity, fiber integrity, and vascularity of the tendon. The comparison related to chronological age documented a morphologic change of the greater tuberosity and progressive degeneration of all elements of the tendinous structures with progressive (1) osteitis of the greater tuberosity, cystic degeneration, and irregularity of the cortical margin; (2) degenerative sulcus between the greater tuberosity and the articular surface; (3) disruption of the integrity of the attachment of the tendon to the bone by Sharpey's fibers; (4) loss of cellularity, loss of staining quality, and fragmentation of the tendon; (5) diminution of the vascularity of the tendon; and (6) diminution of fibrocartilage.

Adult↗
PubMed1997

Rotator-cuff tear of the hip.

We describe an apparently unreported finding during hip operations: a tear at the insertion of gluteus medius and gluteus minimus. This defect may well be known to many surgeons with experience of hip replacement and hemiarthroplasty for fractures of the neck of the femur, but a Medline search has failed to find a previous description. We made a prospective study of 50 consecutive patients with fractures of the neck of the femur to quantify the incidence of this condition: 11 (22%) had such a tear.

Aged↗