Rotator cuff tears and associated nerve injuries

A series of 15 patients with concomitant rotator cuff tears and infraclavicular brachial plexus injuries treated between 1980 and 1989 were reviewed. There were 6 men and 9 women with a mean age of 65 years. Seventeen nerve injuries were identified, including 12 axillary nerves, 4 suprascapular nerves, and 1 musculocutaneous nerve. One patient had an injury to all three nerves. Thirteen patients underwent operative repair of the torn rotator cuff, and 2 patients who refused surgery were treated conservatively. The average time from injury to surgery was 7.7 months. Follow-up averaged 5.5 years (range: 2-10 years). Clinical results were graded according to pain, range of motion, and strength. Postoperatively, mean active forward elevation was 137 degrees and mean active external rotation was 40 degrees. Clinically, 8 patients achieved complete nerve recovery and 7 had an incomplete recovery. Satisfactory pain relief was achieved in 87% of patients with 60% having excellent or good function. Overall, the results of rotator cuff repair with concurrent nerve injury are less favorable than those of isolated cuff repairs. Careful preoperative assessment of concomitant nerve injury should be performed to better predict outcome.