15 de jul. 2017

"lag sign" i rodo menor en massives i CTA

"lag sign" i rodo menor  en massives i  CTA
Clinical Orthopaedics and Related Research®Volume 473, Issue 9, pp 2959–2966

Clinical signs can predict anatomic patterns of teres minor dysfunction with good accuracy in patients with massive rotator cuff tears. This study showed that the most accurate test for teres minor dysfunction is an external rotation lag sign and that most patients’ posterior rotator cuff tears do not lose active external rotation. Because imaging is not always accurate, examination for integrity of the teres minor is important because it may be one of the most important variables affecting the outcome of reverse shoulder arthroplasty for massive rotator cuff tears, and the functional effects of tears in this muscle on day to day activities can be significant. Additionally, teres minor integrity affects the outcomes of tendon transfers, therefore knowledge of its condition is important in planning repairs.


Fig. 1A–B
(A) The external rotation lag sign is performed with the patient seated with the elbow flexed to 90° and the shoulder elevated 20° in the scapular plane. The arm is passively taken to maximal external rotation minus 5° to allow for elastic recoil. (B) The patient was asked to maintain that position as the clinician released the wrist. A positive test is defined as any internal rotation greater than 10°.




(A) The drop sign is a lag sign beginning from 90° abduction in the scapular plane, with elbow flexion of 90°, and external rotation of the shoulder to 90°. From this position, the patient is asked to maintain the position against gravity (Medical Research Council Grade 3).

(B) Failure to resist gravity and internal rotation of the arm is considered a positive drop sign.