Trauma-related rotator cuff injury. Scientific basis and consequences for legal assessment

The traumatic etiology of rotator cuff lesions is a matter of controversial discussed in legal assessments. Because of the relatively high prevalence of degenerative changes with increasing age,including partial and complete rotator cuff tears, it may be difficult to demonstrate the cause of an acut e traumatic rotator cuff tear. This article presents a review of the literature concerning current knowled ge of the anatomy, biomechanics and pathogenesis of rotator cuff pathology. According to this, a catalogue of potentially adequate and inadequate trau ma mechanisms is proposed. Another focus of this work is in the posttraumat ic diagnostic steps following persistent rotator cuff-deficient shoulder fu nction. X-ray, ultrasound, MRI and operative findings in rotator cuff tears underline the criteria for distinguishing between traumatic and degenerati ve lesions. From a legal point of view (e.g., private accident insurance, workers compe nsation claims),various minor and major arguments are defined,which could h elp the expert in judging the cause of posttraumatic rotator cuff deficienc y.