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J Shoulder Elbow Surg. 2012 Jan;21(1):72-6. doi: 10.1016/j.jse.2011.01.038. Epub 2011 Mar 12.

Supraspinatus rupture at the musclotendinous junction: an uncommonly recognized phenomenon.

Author information

1
Department of Surgery, Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland. alexandre.laedermann@hcuge.ch

Abstract

BACKGROUND:

The majority of rotator cuff lesions involving the supraspinatus occur at or near the level of bone-tendon interface. We present a series of supraspinatus injuries at the musculotendinous junction.

METHODS:

Between October 2002 and December 2009, we prospectively evaluated all patients presenting with an injury of the supraspinatus at the musculotendinous junction.

RESULTS:

Five patients (1 female and 4 males) were identified. Three patients had a clear history of trauma. All patients presented acutely with pain and muscular edema on T2 magnetic resonance imaging (MRI) sequences. Lesions were characterized as stretch injuries in 2 cases and complete rupture at the level of the musculotendinous junction in 3 cases. Electrodiagnostic studies were normal in all cases. All patients were treated nonoperatively. On clinical and radiological examination at an average of 24 ± 10 months (range, 10-38), 1 patient had complete clinical and radiological resolution, 1 improved, and 3 who complained of loss of function demonstrated severe fatty infiltration on MRI.

CONCLUSION:

Musculotendinous rupture of the supraspinatus is an unusual lesion of the rotator cuff. With incomplete injuries, recovery can be anticipated with nonsurgical management. However, in the case of a complete rupture with muscle retraction, nonoperative management leads to unsatisfactory outcomes.

PMID:
21398147
DOI:
10.1016/j.jse.2011.01.038
[Indexed for MEDLINE]

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