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International Orthopaedics
Published in: International Orthopaedics 6/2021

Open Access 01-06-2021 | Painful Arc | Review Article

Can a simple fall cause a rotator cuff tear? Literature review and biomechanical considerations

Authors: Richard W. Nyffeler, Nicholas Schenk, Philipp Bissig

Published in: International Orthopaedics | Issue 6/2021

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Abstract

Purpose

A simple fall on the shoulder is often referred to as minor trauma that cannot cause a tendon tear but at best reveal a pre-existing rotator cuff pathology. We wanted to know whether this statement was true. The purpose of our study was therefore to summarize the causes of acute rotator cuff tears reported in the literature and provide a biomechanical explanation for tendon tears diagnosed after a fall.

Method

We searched PubMed and included studies reporting rotator cuff tears occurring due to a trauma. The number of cases, the tendons involved, the age of the patients, and the nature of trauma were summarized. In addition, we noted any information provided by the authors on the pathogenesis of acute tendon ruptures.

Results

Sixty-seven articles with a total of 4061 traumatic rotator cuff tears met the inclusion criteria. A simple fall was the most common cause (725 cases) and the supraspinatus tendon was most frequently affected. The postulated pathomechanism is a sudden stretch of the tendon-muscle unit while contracting (eccentric loading).

Conclusion

A simple fall can cause an acute rotator cuff tear and fall-related tears are not restricted to young individuals. They can affect patients of any age. The stresses occurring within the rotator cuff during an attempt to cushion a fall may locally exceed the tensile strength of the tendon fibers and cause a partial or full-thickness tear.
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Metadata
Title
Can a simple fall cause a rotator cuff tear? Literature review and biomechanical considerations
Authors
Richard W. Nyffeler
Nicholas Schenk
Philipp Bissig
Publication date
01-06-2021
Publisher
Springer Berlin Heidelberg
Keyword
Painful Arc
Published in
International Orthopaedics / Issue 6/2021
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-021-05012-6

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