Rupture of the musculotendinous cuff of the shoulder

Codman established the diagnostic criteria and treatment for musculotendinous cuff rupture over 40 years ago. Chronic shoulder pain after a history of trauma which is unresponsive to usual conservative treatment may indicate rotator cuff tear. Point tenderness, weakness of abduction and external rotation, atrophy, and palpable crepitus or a gap are confirming signs. X-rays may be negative in the acute injury but show definite changes with chronicity. An arthrogram confirms the presence of a tear. An electromyograph should be performed to rule out suprascapular nerve lesions. Surgical repair will result in good or excellent results in at least two-thirds of cases properly selected. Complications which can adversely influence the results include deltoid avulsion, residual impingement and ectopic bone formation. A successful repair is generally permanent.