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[Subacromial hematoma due to rotator cuff rupture]
Alexander Rozin1, Alicia Nachtigal, Ilana Oren
1Shein Department of Rheumatology, Rambam Medical Center and Rappaport Faculty of Medicine, Technion, Haifa, Israel. a_rozin@rambam.health.gov.il
Harefuah
|August 9, 2005
Summary
This case report details an elderly patient with rotator cuff rupture and subacromial hematoma. Conservative therapy and deltoid muscle compensation restored shoulder function, highlighting a less invasive approach for seniors.
Area of Science:
- Orthopedics
- Sports Medicine
- Geriatric Care
Background:
- Spontaneous acute rotator cuff rupture is uncommon, particularly in the elderly.
- Subacromial hematoma formation can complicate rotator cuff injuries, causing significant pain and limited mobility.
Observation:
- An elderly patient presented with acute rotator cuff rupture and a large subacromial hematoma.
- Aspiration of the hematoma provided substantial pain relief.
- Shoulder function was restored within one month through conservative management.
Findings:
- Hematoma fluid analysis revealed severe lactic acidosis and low glucose levels, with preserved red blood cells and decreased white blood cells.
- Blood analysis showed normal complete blood count (CBC), pH, lactate, and glucose.
- Leukocytes demonstrated high susceptibility to anaerobic/acidic conditions and oxygen dependency.
Implications:
- Conservative management, including aspiration and physical therapy, can be effective for rotator cuff rupture in the elderly.
- The deltoid muscle's compensatory role is crucial for restoring shoulder function in older adults.
- Findings suggest potential insights into leukocyte behavior in hypoxic and acidic environments, relevant to inflammatory processes.