Sunday, October 13, 2013

Are massive cuff tears associated with suprascapular neuropathy?

Neuropathy of the suprascapular nerve and massive rotator cuff tears: a prospective electromyographic study

Some have suggested that suprascapular neuropathy contributes to the dysfunction of shoulders with massive cuff tears and deserves particular surgical attention.

These authors prospectively evaluated the suprascapular nerve function using electromyography in 49  patients with retracted tears of both supraspinatus and infraspinatus. Six (12%) had neurologic lesions noted on electromyography: 1 suprascapular nerve neuropathy, 1 radicular lesion of the C5 root, 1 affected electromyogram in the context of a previous stroke, and 3 cases of partial axillary nerve palsy with a history of shoulder dislocation. No difference or diminution of the latency or amplitude of the electromyogram was found in the cases that presented with significant fatty infiltration.

A suprascapular lesion was not found in the majority of cases of massive cuff tears. The authors' evidence does not support the routine practice of suprascapular nerve release when cuff repair is performed.

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