Posttraumatische rotatorenmanschettenläsionen

Abstract

Background. The increasing incidence of rotator cuff tears with increasing age indicates that rotator cuff lesions are naturally correlated with ageing and often present without clinical symptoms. Rotator cuff tears from extrinsic causes, i.e. repetitive microtrauma or even macrotrauma, are different entities. Because of the strong and stiff tendon tissue, direct injury mechanisms may not lead to a rotator cuff tear. Excentric mechanisms of tensioned tendons or shearing forces during dislocation may, on the other hand, result in traumatic rotator cuff tears. Evaluation. For the decision from a legal point of view of whether it is a traumatic or degenerative rotator cuff tear, an individual- and patient-related analysis of all circumstances and information including radiographs or MRI is necessary. Therapy. Reconstruction of the tear is indicated especially in younger patients as well with a history of relevant trauma or of dislocation. The operation should be performed early, if associated with concomitant neurologic lesions. Good to very good results are achieved using open or arthroscopic techniques in the short and long-term follow-up. © Springer-Verlag Berlin Heidelberg 2013.