Not Just Another Shoulder Injury - Page #4
 

Working Diagnosis:
Isolated teres minor rupture.

Treatment:
The patient was given oral anti-inflammatory mediacatoins and placed in a sling for comfort for one week. At that time the sling was discontinued and the patient began an eight week course of aggresive physcialt thearpy and rehab.

Outcome:
The patient had an excellent outcome with conservative treatment. She was able to compete in the upcoming season and had no difficulty with any basketball movments. She obtained full pain free range of motion in all planes. On strength testing she had no defecits in comparrison to her contralateral extremity.

Author's Comments:
Rotator cuff injuries are common in every day practice. The literature, however, is scarce in describing the presentation and management of isolated teres minor ruptures. The use of the “dropping sign" (case photo 4,5, and 6) and "horn blower’s sign” )(case photo 3) can be used to help isolate injuries to either the infraspinatus or teres minor muscles. As seen in our patient, although a rare injury, with aggressive physical therapy long term outcomes for isolated teres minor rupture appear favorable.

References:
1. Wheeless, Clifford. “Wheeless’ textbook of orthopaedics.” 14 Jan. 2009. 12 Aug. 2010. http://www.wheelessonline.com/ortho/teres_minor.

2. DeLee, Jesse. Drez, David. Miller, Mark. DeLee and Drez’s Orthopaedic Sports Medicine, 3rd Edition. Philadelphia, PA. (556).

3. DeLee, Jesse. Drez, David. Miller, Mark. DeLee and Drez’s Orthopaedic Sports Medicine, 3rd Edition. Philadelphia, PA. (991).

4. Walsh, Gilles. Et al. “The “dropping” and “horn blower’s” signs in evaluation of rotator –cuff tears.” The journal of bone and joint surgery. 4 July. 1998. 624-628.

5. Okino, S. Miyaji, H. Matoba, M. “The quadrilateral space syndrome.” Diagnostic Neuroadiology. 27 December. 1993. 311-312.

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