The association of suprascapular neuropathy with massive rotator cuff tears: a preliminary report.
We studied a prospective, consecutive series of 8 patients presenting with massive rotator cuff tears (>5 cm. in maximum dimension), all associated with severe retraction and fatty infiltration of the supraspinatus muscle on magnetic resonance imaging studies. All 8 patients had suprascapular neuropathy shown by electromyography (EMG) findings of denervation in the supraspinatus and/or infraspinatus muscles. Clinically, all patients had severe limitation of active motion, with no patient able to elevate their affected arm actively >40 degrees . Four patients elected débridement and partial surgical repair using margin convergence principles via a mini-open approach. Follow-up of these patients averaged 24 months. All 4 patients regained the ability to elevate their affected arm to >90 degrees , and to place their hand actively behind their head without assistance. Two of the 4 surgical patients consented to follow-up EMG studies that demonstrated, in both cases, that the suprascapular nerve had significant renervation potentials, with almost complete recovery of the nerve in 1 case. We conclude that suprascapular neuropathy may be associated with massive rotator cuff tears, and that partial rotator cuff repair may allow recovery of the nerve and improvement of function.
Mallon
William J
WJ
Triangle Orthopaedic Associates, Durham, NC 27704, USA. bmallon@nc.rr.com
Wilson
Robert J
RJ
Basamania
Carl J
CJ
D000368:Aged; D006801:Humans; D015601:Injury Severity Score; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000150:complications*; D011446:Prospective Studies; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012540:Scapula