Verletzungen der Rotatorenmanschette

Abstract

When treatment is needed for rotator cuff tears it is important to differentiate between traumatic and degenerative forms and to proceed according to a finely varied treatment schedule. History, physical condition and clinical functional assessment of the rotator cuff are of decisive importance in the detailed diagnosis. X-Ray examination of the shoulder is mandatory and should be supplemented by ultrasound or MRI whenever internal damage of the shoulder joint is suspected. There is some controversy about the treatment of rotator cuff tears, some recommending conservative treatment and others, immediate surgery. Indications for the latter are traumatic tears, status following shoulder dislocation and desire in the patient for functional improvement. Surgical treatment is absolutely contraindicated in inactive or noncompliant patients and in patients with concomitant frozen shoulder (inckuding those with some movement in the joint), arthritis of the shoulder and omarthritis. Tears together with muscles that have already undergone degenerative alteration should initially be treated conservatively. In the presence of any additional defect caused by arthropathy and of pain persisting after conservative treatment an inverse shoulder prosthesis can be indicated. © 2007 Springer Medizin Verlag.