Rotator cuff rupture: management with suprascapular neuropathy

In patients with shoulder pain, weakness, and limitation of motion from rupture of the rotator cuff, there may be concomitant suprascapular neuropathy. In five patients with partial tears and one postsurgical patient with a complete tear of the rotator cuff, confirmed by arthrography, shoulder pain and weakness persisted 6 to 10 weeks after trauma. Electrodiagnosis in all six patients demonstrated prolonged suprascapular distal nerve latencies to the involved infraspinatus muscles. During the first 5 months after trauma, clinical recovery was much more rapid than later. Eight months after injury, despite conservative therapy, some discomfort remained and electrodiagnostic values had not completely returned to normal. The combination of a torn rotator cuff and a suprascapular neuropathy can present a complex diagnostic and management challenge, suggesting the importance of alertness to the possibility of such a combination in patients with tears of the rotator cuff.