Rotator Cuff RuptureThe detection and treatment of Rotatorenmanschettenruptur lead us in a joint clinic by. The far-reaching significance of this injury, the possibilities and risks of treatment after the diagnosis and assessment of damage extent essential task of the treating physician.
What is a Rotatorenmanschettenruptur?
We denote as Rotatorenmanschettenruptur a change or violation of the tendon hood, which surrounds the upper head. It has an essential function in the arm motion and may have different restrictions to be overburdened.
It can be a strong violation of the shoulder injury as a fresh, or as part of a degenerative injury of the shoulder during prolonged mechanical irritation in the shoulder roof occur. This creates wear and tear tendons in the framework of a so-called Engpassyndroms (impingement syndrome) of the shoulder.
The extent of the damage is very different. Partial tendon tears, complete small cracks, large cracks or complete Massenrupturen called the rotator cuff are deferred and are crucial for the therapeutic possibilities and necessity. In the joint clinic Gundelfingen make the therapy depends on many parameters, which we in the personal interview to discuss in detail.
Which functions are disturbed when Rotatorenmanschettenruptur?
The function of the rotator cuff explains clearly why the tear in the tendon hood a serious impairment of shoulder function. The biomechanics is massively disrupted.
The best understanding of our patients the problem of injury to the tendon through the hood, pictorial analogy. The upper head is similar to a ball, by a dense cover is coated. In the event of damage to the hood, it is with increasing size of the Rotatorenmanschettenrisses a passage to the top of the head under the shoulder roof.
This explains why, in the course of the disease to more changes coming. The resulting changes are called rotator cuff arthropathy-described. The upper head is moved in contact with the shoulder bone and the roof shows increasing changes.
The disturbed function of the shoulder is dependent on the main portion of the damaged tendon. As well as the possible compensatory mechanisms of the neighboring tendon units.
A self-healing of the rotator cuff is usually not.
What symptoms occur when Rotatorenmanschettenruptur on?
Small tears of the rotator cuff can occur without symptoms or only a short time causing discomfort. Larger Rotatorenmanschettenrisse are often associated with a noticeable snap together. Especially little pain occur in wear-related diseases. These are therefore often not recognized.
The shoulder pain often begin the front (ventral) or lateral (lateral) of the Akromions and radiate into the shoulder or in the muscles of the upper arm and the forearm from. By Abspreizung against a resistance, by rotation of the arm and load arm increases the pain. The Tuberculum majus humeri pressure is painful.
Rest pain is also described as an inability on the affected shoulder to lie. For precise inquiries is often but a force reduction of the arm is described.
We consult closely with the shoulder pain and limitations and use this information for accurate diagnosis and thus to develop an individualized treatment plan.
Who is affected by a Rotatorenmanschettenruptur or injury to the tendon hood affected?
The Rotatorenmanschettenruptur often occurs. Approximately 25% of the fifty-year-olds and about 50% of Siebzigjährigen is statistically affected. Men are often affected than women. Frequent hand-work is concerned, mostly the right.
How we make the diagnosis of Rotatorenmanschettenruptur?
A detailed medical history survey and a meticulous examination of the shoulder is essential for assessing the damage, the prognosis and the functional limitation. Certain agencies are in the clinical investigation of painful pressure and certain movements are painful or can not be carried out.
What Rotatorenmanschettenruptur therapy in a sense, it can very much by a so-called ultrasound examination of the shoulder can be determined. The main advantage of this method is that you live under quasi-movement of the arm to assess the damage. This advantage, all other diagnostic methods are not mentioned.
The X-ray examination is only in advanced stages of Rotatorenmanschettenruptur changed, a higher force of the upper head is demonstrated. Even changes in the upper head of the changing pressures are displayed.
Without reference to the impact of the shoulder joint can Sehnenriss under a Kernspinntomografischen study are presented. This static analysis helps us to evaluate the most affected muscle. If a muscle after a rift over a long period is not enabled, then creates a reduction of adiposity and muscle belly (fatty degeneration). If this is detectable, then a seam of the tendon no successful treatment.
What treatment options are available?It is important to choose the right therapies.
There are conservative and operative therapies are available.
Patients with minor complaints and earlier damage to the small rotator cuff can be treated conservatively.
Here are the following therapies are recommended.
- Analgesia with anti-inflammatory drugs
- Physical therapy
- Physiotherapy with the aim of the preservation movement and pain relief, then the strength and compensate for damage caused by adjacent tendons shares.
- Regular monitoring of the injury.
Surgical therapy:
The Rotatorenmanschettenruptur may, depending on the location, size, age of the violation and the complaints in an open or arthroscopic surgical techniques to be. The arthroscopic procedure is also called "keyhole surgery therapy".
Both methods are torn tendons or sealed the crack decreases.
When is a surgical therapy of Rotatorenmanschettenrisses recommended?
- With very strong shoulder pain and restriction
- high demands on the shoulder mobility, for example, in athletes
- Treatment failure after 6 months
