Shoulder Flashcards
Adult >40 with shoulder dislocation has high rate of:
rotator cuff tear
Which phase of throwing has highest tensile strain on the cuff?
deceleration phase
Size of supraspinatus footprint
12.7mm on anterosuperior greater tuberostiy. Thus a 50% tear is 6mm long.
Most rotator cuffs occur on this side of the cuff:
articular side. Because articular side is 50% tensile strength of the bursal side.
Which cuff side is most vascular?
Bursal side, therefore more likely to heal
Contents of the rotator interval
SGHL, CHL, capsule
The Rotator Cable
fibers from the CHL, perpendicular to the Supraspinatus,
see a subscap tear and think…
subcoracoid impingement
Massive rotator cuff tear definition
> 5cm, t ypically involving more than 1 tendon
Ellman Classification of Partial Cuff Tears
1: <3mm/<25%
2: 3-6mm/25-50%
3. >6mm/>50%
subclassified as A (articular) B (bursal) or I (intradentinous)
Goutallier Classification
Cuff Atrophy
- Normal tissue
- some fatty streaks
- more muscle than fat
- more fat than muscle
Night pain in a rotator cuff tear suggests:
worse non-operative otucomes
Medial biceps tendon subluxation suggest:
Subscapularis tear
Tangent sign:
supraspinatus atrophy. Does not cross a line between the scapular spine and the coracoid on the sagittal MRI
What %age of asymptomatic patients >60 have a RCT?
55%
What size bursal sided cuff tear needs repair?
> 25%
msut be treated more aggressively than articular sided tears