[Injury of the rotator cuff. II. Diagnostic and therapeutic problems]

Authors examined the clinical problems of the rotator cuff injuries. The possibilities of the early diagnosis are reviewed and the significance of the detailed physical examination and of the shoulder arthrography stressed. The indication of the conservative and operative treatment is defined and also the optimal time of the reconstructive operation. In massive tears, in young age, the early diagnosis and the necessity of the urgent operations is stressed whereas in degenerative alterations, before the operative therapy of the cuff defects, in every case complex physiotherapeutic treatment is suggested. It is underlined that the operative results are improved by the good exposure, the possibly simple and reliable closure of the defect with a synchronous widening of the space under the shoulder vault. Because of the great variety of the injuries an individually chosen functional aftertreatment of many months is thought necessary.