THE INFLUENCE OF VARIATIONS OF THE CORACOACROMIAL ARCH ON THE DEVELOPMENT OF ROTATOR CUFF TEARS

GOHLKE F BARTHEL T GANDORFER A

F. Gohlke et al., THE INFLUENCE OF VARIATIONS OF THE CORACOACROMIAL ARCH ON THE DEVELOPMENT OF ROTATOR CUFF TEARS, Archives of orthopaedic and trauma surgery, 113(1), 1993, pp. 28-32

20

INGLESE

Article

Orthopedics,Surgery

Archives of orthopaedic and trauma surgery → ACNP

0936-8051

113

1

1993

28 - 32

ISI

0936-8051(1993)113:1<28:TIOVOT>2.0.ZU;2-U

In order to define the geometry of the coracoacromial arch in both its bony and soft parts and to bring it into relationship with rotator cu ff tears, 54 cadaver shoulders (from subjects aged 47-90 years) were d issected and X-rayed (anteroposterior projection and supraspinatus out let view). Partial rotator cuff tears were assessed additionally by tr ansillumination and polarized microscopy. After transfixation of the c oracoacromial arch with a polyurethane mould, sections were made along the coracoacromial ligament. The morphology of the acromion was descr ibed following the classification of Bigliani et al. [5]. Amongst othe r parameters, measurements were taken between the long axis of the sca pula, the spina, and the acromion. In 19 of 22 cases, a traction osteo phyte was associated with rotator cuff tears. In incomplete tears, spu rs were completely encased within the ligament and did not impair the subacromial space. The number of rotator cuff tears was significantly increased in shoulders with ''curved'' acromia, flat acromial slope, a nd increased angle between the scapular plane and the spina (intact, m ean 58 degrees; tears, mean 47 degrees). The morphology of the subacro mial space was secondarily determined by this angle. In contrast to Bi gliani et al. we were unable to find a ''hooked'' acromion. These resu lts indicate that the combination of a flat and curved acromion or a p osition of the acromioclavicular joint above the cranial pole of the g lenoid must be regarded as considerable risks for the development of r otator cuff tears. The concept of anterior acromioplasty is supported by our results.