[Development and assessment of so-called rotator cuff ruptures].

The following conclusions can be drawn from our investigations: We could not find out isolated ruptures of the supraspinatus tendon, which were caused exclusively by injury. Mostly ruptures of the rotatory cuff develop spontaneously, the basic degenerative changes involve also the shoulder joint and the acromioclavicular joint. The term rupture of rotatory cuff is misleading, because it signals to the patient the existence of aftermath of injuries and for the most part the rupture is not found in the tendons of the rotatory muscles but in the supraspinatus tendon. The degenerative cuff defects with spontaneous ruptures must be differentiated in medical certificate from the rare rotatory cuff ruptures, which are caused by injury alone. Seldom exogenous mechanical stress may lead to an enlargement of a preexistent rupture with symptoms and clinical signs, which occur for the first time. On the promises, that an adequate injury has occurred, that roentgenographic changes deteriorated within 3 months after the injury and a degenerative defect of rotatory cuff with clinical relevance can be excluded for the time before the injury, the damage of the shoulder has to be accepted by the insurance as an injury after accident. In the most times occasional causes with inadequate injuries to the shoulder are brought up, to assert an old degenerative defect of the shoulder as an aftermath of injury. There are no interrelations between intraoperative findings and mechanism of injury. The anamnestic statement of the patient concerning earlier diseases and injuries are often unreliable.(ABSTRACT TRUNCATED AT 250 WORDS)