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Proximal Humerus Fractures and Shoulder Dislocations: Prevalence of concomitant Rotator Cuff Tear
ESSKA Academy. Elamin-Ahmed H. May 9, 2018; 209907; P22-1660 Topic: Anatomy
Dr. Hussam Elamin-Ahmed
Dr. Hussam Elamin-Ahmed
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Abstract
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Objectives: Proximal Humerus Fractures and Rotator Cuff Tears are more common with advancing age, whilst there is an increased prevalence of Rotator Cuff Tears in those sustaining a Shoulder Dislocation over the age of 40 years of age.

With this in mind, the objective of the study was to assess the prevalence of a concomitant Rotator Cuff Tear within three patient populations:
1. Proximal Humerus Fractures
2. Shoulder Dislocations
3. Proximal Humerus Fracture-Dislocations

Methods: Retrospective review of three patient populations:
1. Proximal Humerus Fractures
2. Shoulder Dislocations
3. Proximal Humerus Fracture-Dislocations

The time period that the retrospective review encompassed was between August 2012 and August 2014. All patients within the three groups presented to and underwent subsequent management of their shoulder injury at a District General Hospital. Management included both non-operative and operative intervention.

Results: This study reviewed 196 patients:
Group 1 = 146 Proximal Humerus Fractures
Group 2 = 37 Shoulder Dislocations
Group 3 = 13 Proximal Humerus Fracture-Dislocations

Of the 196 patients in total, 23 (11.9%) sustained concomitant Rotator Cuff Tears. The highest number of tears was found to be in Group 1 (n = 14). However the highest percentage of tears was in Group 2 (18.9%).

There was noted to be a higher prevalence of Rotator Cuff Tears with increasing age. Those with a Rotator Cuff Tear tended to be older (average age, 71.7 vs 67.5 years). Of the 23 total concomitant Rotator Cuff Tears, 19 (82.6%) were detected in those over 60 years of age.

The vast majority of Rotator Cuff Tears were detected by Ultrasound (78.3%) as opposed to MRI (21.7%). The majority of tears were full-thickness in nature (60.9%). A tear involving Supraspinatous was most common (69.6%). Of the 23 concomitant Rotator Cuff Tears, 17 involved a single tendon (73.9%).

Conclusions: A concomitant Rotator Cuff Tear in association with a Proximal Humerus Fracture, Shoulder Dislocation or Proximal Humerus Fracture-Dislocation is relatively common. The Overall Rotator Cuff Tear Prevalence in this study was 11.9%. Rotator Cuff Tears are more likely to occur in older patients and those sustaining a dislocation.

Keywords:
Rotator Cuff Tear, Proximal Humerus Fracture, Shoulder Dislocation, Proximal Humerus Fracture-Dislocation, Prevalence
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