If they are not having much PAIN and are just limited by weakness – not sure exactly how this changes things. Typically, in older patients we operate to help the pain. If a young patient were to sustain a sudden injury and have rotator cuff symptoms, that patient I’d fix right away.
– the best test for rotator cuff after MRI is arthrography.
– acromial morphology is best associated with incidence of full thickness rotator cuff tearing. (Type III)
– adhesive capsulitis is seen with diabetics in particular. Also with other “fibromatosis” – peyronies, dupuytrens, plantar fibromatosis, Garrods nodes, hypothyroidism, phenobarbitol use.
– for the acute proximal biceps tendon rupture – do nothing; physio to get them moving. No reason to go in and fix.
– Charcot arthropathy secondary to syrinx – NONoperative Rx only.
– onset of shoulder pain with deltoid atrophy and triceps atrophy – C5 and C7 – weird. Probably a plexus neuritis to affect them both.
– the most important risk factor for clavicular nonunion is displacement of fracture
– staple capsuloraphy has a high rate of complication when used in the shoulder; all arthroscopic stapling procedures are frought with complications.
– the pitcher subluxes his shoulder during late cocking (begins with the pitcher putting his foot down); The severe abduction and external rotation in late cocking causes posterosuperior impingement and levers the anterior head out the front – thus stretching out the anterior capsule. The rotator cuff hast to work harder to keep the shoulder in. When the cuff fatigues – more instability. Note: if this pt comes in with labral pathology, you need to address the instability primarily, not just the labral pathology.
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