William J. Mallon MD, Robert J. Wilson MD and Carl J. Basamania MD
This is a study of a prospective, consecutive series of 8 patients presenting with massive rotator cuff tears, 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 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 >40Â°. Four patients elected dÃ©bridement and partial surgical repair using margin convergence principles via a mini-open approach. All 4 patients regained the ability to elevate their affected arm to >90Â°, 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.
Journal of Shoulder and Elbow Surgery Volume 15, Issue 4 July-August 2006, Pages 395-398