Evaluation Treatment of the Rotator Cuff Injury: Correlations Between of the Insertional Anatomy Site Lesions and a Functional of Postoperative Results

Zoran Hadziahmetovic1, Narcisa Vavra – Hadziahmetovic2 Clinic for Emergency medicine, Clinical center of Sarajevo University, Bosnia and Herzegovina1, Clinic for Physical medicine and rehabilitation, Clinical center of Sarajevo University, Bosnia and Herzegovina2 tor of the arm where infraspinatus shoes more power in outer rotation of the shoulder compared to teres minor. Kineziologically they represent anatomical and functional system. With its tone they act as active links of the shoulder joint because they assure the contact between humerus head with cavitas glenoidalis scapulae. If we observe only lateral shoulder rotators (mm. infraspinatus and teres minor) they participates in moves of horizontal adduction of the upper arm; upper fibers of m.infraspinatus in flexion of upper arm, and lover in adduction. Outer rotation of the forearm is according to muscle power weaker movement compared to the inner rotation. Injuries of the RC can be expressed in form of partial or complete rupture or asymptomatic as subacromial impingement syndrome which is expressed with the characteristic signs which involves subacromial pain, crepitating and impossibility to elevate limb. Prevalence of RC increases with age: so that the patients without RC rupture are at the average age of 19 years, and with the unilateral rupture 59 year, and with bilateral rupture at 68 years (1). Main cause of impingement is repeated touching (collision) of humerus head with lower surface of the frontal part of acromion and coracocromial ligament. Most often involved tendons are one of supraspinatus and infraspinatus. But similar symptoms can be caused by other important anatomic structures such as subacromial burs and tendon of the biceps long head. Clinical tests which are specific for determining impingement and RC lesion are functional tests; Neer, hawkins – Kennedy and adductive (drop arm) tests which determines the degree of limitations for active adduction of the upper arm. Painful adduction, subacromial painful arch in range from 30 0 to 120 o (involved structures of the subacromial joint) goes in favor of partial rupture and painful impossible initial adduction of the upper arm to complete rupture. Noticeable is the disorder of the humoroscapular rhythm. Verification of the muscle strength weakness should be evaluated by the group test for the lateral rotators of the shoulder which is performed and evalu148-152