Missed rotator cuff tear and lower trap transfer
A laborer in his 50s came to my office today with complaints of left shoulder pain. He had injured it a year ago in a fall and had initially seen another provider who gave him a cortisone shot. He had been doing reasonably well but continued to have pain and weakness and tried to work through it . He eventually saw his primary doctor and got an MRI before being sent to me, again almost a year later. On exam the man was very weak when I tested his rotator cuff. On MRI the patient had a massive rotator cuff tear with development of atrophy (fatty infiltration) of his rotator cuff muscles. Whereas we probably could have fixed his rotator cuff a year ago and he would have likely been healed, the tear was now no longer repairable. Thankfully, I am able to offer him a recently developed reconstructive procedure called a lower trapezius transfer, which has been very successful for treating these types of patients in salvage situations.
