The 'dropping' and 'hornblower's' signs in evaluation of rotator-cuff tears

• Published in: Journal of bone and joint surgery. British volume Vol. 80; no. 4; pp. 624 - 628
• Main Authors: WALCH, G, BOULAHIA, A, CALDERONE, S, ROBINSON, A. H. N
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.07.1998; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Activities of Daily Living; Adipose Tissue - pathology; Aged; Aged, 80 and over; Biological and medical sciences; Evaluation Studies as Topic; Female; Humans; Hypertrophy; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Muscle, Skeletal - pathology; Muscular Diseases - pathology; Osteoarticular system. Muscles; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Range of Motion, Articular - physiology; Rotation; Rotator Cuff - physiopathology; Rotator Cuff - surgery; Rotator Cuff Injuries; Rupture; Sensitivity and Specificity; Shoulder - pathology; Shoulder Joint - physiopathology; Treatment Outcome; Juxtaarticular disease; Human; Adipose tissue; Methodology; Diseases of the osteoarticular system; Trauma; Sensitivity; Specificity; Correlation analysis; Shoulder; Tissue rupture; Thoracic girdle; Degeneration; Clinical investigation; Diagnosis; Technique; Rotator cuff
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620X.80B4.0800624

We studied 54 patients operated on for combined supraspinatus and infraspinatus rotator-cuff tears. The presence or absence of the dropping and hornblower's clinical signs of impaired external rotation were correlated with Goutallier stage-3 or stage-4 fatty degeneration of infraspinatus and teres minor. These grades of fatty degeneration have previously been correlated with a poorer outcome from reconstructive surgery. We found that hornblower's sign had 100% sensitivity and 93% specificity for irreparable degeneration of teres minor and the dropping sign 100% sensitivity and 100% specificity for similar degeneration of infraspinatus. In seven patients, teres minor showed hypertrophy. This muscle can give useful function for the activities of daily living in patients with rotator-cuff tears in whom it is intact.