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Shoulder external rotation contracture

MedGen UID:
592328
•Concept ID:
C0409331
•
Acquired Abnormality
Synonyms: External rotation contracture of shoulder; External rotation contracture of the shoulder joint; External rotation contracture-shoulder
SNOMED CT: External rotation contracture-shoulder (202270003); External rotation contracture of shoulder (202270003)
 
HPO: HP:0034991

Definition

A type of shoulder contracture characterized by decreased internal rotation of shoulder, that is, by a chronic reduction in active and passive ability to internally rotate the humerus at the shoulder joint (if the arm is flexed at the elbow, Internal rotation of the shoulder rotates the forearm towards the center of the body). [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVShoulder external rotation contracture

Professional guidelines

PubMed

Exercise and sports science Australia (ESSA) position statement on exercise and spinal cord injury.
Tweedy SM, Beckman EM, Geraghty TJ, Theisen D, Perret C, Harvey LA, Vanlandewijck YC
J Sci Med Sport 2017 Feb;20(2):108-115. Epub 2016 Mar 9 doi: 10.1016/j.jsams.2016.02.001. PMID: 27185457
Use of botulinum toxin type A in the management of neonatal brachial plexus palsy.
Michaud LJ, Louden EJ, Lippert WC, Allgier AJ, Foad SL, Mehlman CT
PM R 2014 Dec;6(12):1107-19. Epub 2014 May 2 doi: 10.1016/j.pmrj.2014.05.002. PMID: 24798262
Management of the subscapularis contracture during shoulder arthroplasty for primary glenohumeral arthritis.
Fama G, Nava P, Pini S, Cossettini MM, Pozzuoli A
Chir Organi Mov 2008 Feb;91(2):71-7. Epub 2008 Mar 3 doi: 10.1007/s12306-007-0012-5. PMID: 18320377

Recent clinical studies

Etiology

Shoulder Motion Overestimated by Mallet Scores.
Lovette M, Chafetz RS, Russo SA, Kozin SH, Zlotolow DA
J Pediatr Orthop 2024 Nov-Dec 01;44(10):e951-e956. Epub 2024 Jul 22 doi: 10.1097/BPO.0000000000002775. PMID: 39034600
Teres major transfer to restore external rotation of shoulder in Erb palsy patients.
Abdelaziz AM, Aldahshan W, Hashem Elsherief FA, Ismail MA, Fouaad AA, Mahmoud WS, Al Akeed T, Said MM
J Shoulder Elbow Surg 2020 May;29(5):941-945. Epub 2019 Nov 20 doi: 10.1016/j.jse.2019.09.017. PMID: 31759877
Exercise and sports science Australia (ESSA) position statement on exercise and spinal cord injury.
Tweedy SM, Beckman EM, Geraghty TJ, Theisen D, Perret C, Harvey LA, Vanlandewijck YC
J Sci Med Sport 2017 Feb;20(2):108-115. Epub 2016 Mar 9 doi: 10.1016/j.jsams.2016.02.001. PMID: 27185457
Mobility and stability adaptations in the shoulder of the overhead athlete: a theoretical and evidence-based perspective.
Borsa PA, Laudner KG, Sauers EL
Sports Med 2008;38(1):17-36. doi: 10.2165/00007256-200838010-00003. PMID: 18081365
Contracture of the shoulder.
Nobuhara K, Sugiyama D, Ikeda H, Makiura M
Clin Orthop Relat Res 1990 May;(254):105-10. PMID: 2323126

Diagnosis

Symptomatic internal impingement of the shoulder in overhead athletes.
Spiegl UJ, Warth RJ, Millett PJ
Sports Med Arthrosc Rev 2014 Jun;22(2):120-9. doi: 10.1097/JSA.0000000000000017. PMID: 24787727
Frozen shoulder.
Robinson CM, Seah KT, Chee YH, Hindle P, Murray IR
J Bone Joint Surg Br 2012 Jan;94(1):1-9. doi: 10.1302/0301-620X.94B1.27093. PMID: 22219239
Internal impingement of the shoulder.
Heyworth BE, Williams RJ 3rd
Am J Sports Med 2009 May;37(5):1024-37. Epub 2008 Dec 4 doi: 10.1177/0363546508324966. PMID: 19059895
Posterior capsular contracture of the shoulder.
Bach HG, Goldberg BA
J Am Acad Orthop Surg 2006 May;14(5):265-77. doi: 10.5435/00124635-200605000-00002. PMID: 16675620
Contracture of the shoulder.
Nobuhara K, Sugiyama D, Ikeda H, Makiura M
Clin Orthop Relat Res 1990 May;(254):105-10. PMID: 2323126

Therapy

Influence of joint volume on range of motion after arthroscopic rotator cuff repair.
Kim JH, Min YK, Kim DY, Park JH, Seo YC, Seo WS
BMC Musculoskelet Disord 2023 Mar 17;24(1):201. doi: 10.1186/s12891-023-06306-z. PMID: 36932406Free PMC Article
Effect of arthroscopic shoulder release on shoulder mobility and bone deformity following brachial plexus birth injury: a systematic review and meta-analysis.
Massamba Vuvu T, Dorniol M, Le Nen D, Thépaut M, Brochard S, Pons C
J Shoulder Elbow Surg 2021 Oct;30(10):2428-2437. Epub 2021 Feb 7 doi: 10.1016/j.jse.2020.12.021. PMID: 33567353
Teres major transfer to restore external rotation of shoulder in Erb palsy patients.
Abdelaziz AM, Aldahshan W, Hashem Elsherief FA, Ismail MA, Fouaad AA, Mahmoud WS, Al Akeed T, Said MM
J Shoulder Elbow Surg 2020 May;29(5):941-945. Epub 2019 Nov 20 doi: 10.1016/j.jse.2019.09.017. PMID: 31759877
External rotation humeral osteotomy for brachial plexus birth palsy.
Bae DS, Waters PM
Tech Hand Up Extrem Surg 2007 Mar;11(1):8-14. doi: 10.1097/01.bth.0000248359.14448.e6. PMID: 17536517
Supportive devices for preventing and treating subluxation of the shoulder after stroke.
Ada L, Foongchomcheay A, Canning C
Cochrane Database Syst Rev 2005 Jan 25;2005(1):CD003863. doi: 10.1002/14651858.CD003863.pub2. PMID: 15674917Free PMC Article

Prognosis

Shoulder Internal Rotation Contracture Formation in Surgically Managed C5, C6 Brachial Plexus Birth Injuries: Neurotmetic Lesions Fare Worse Than Avulsions.
Ulmann ETE, Malessy MJA, Nagels J, Pondaag W
J Bone Joint Surg Am 2022 Nov 16;104(22):2008-2015. Epub 2022 Sep 9 doi: 10.2106/JBJS.22.00373. PMID: 36083976
Relationships Between Capsular Stiffness and Clinical Features in Adhesive Capsulitis of the Shoulder.
Lee SY, Lee KJ, Kim W, Chung SG
PM R 2015 Dec;7(12):1226-1234. Epub 2015 May 21 doi: 10.1016/j.pmrj.2015.05.012. PMID: 26003871
Frozen shoulder.
Robinson CM, Seah KT, Chee YH, Hindle P, Murray IR
J Bone Joint Surg Br 2012 Jan;94(1):1-9. doi: 10.1302/0301-620X.94B1.27093. PMID: 22219239
Long-term outcomes of triangle tilt surgery for obstetric brachial plexus injury.
Nath RK, Liu X, Melcher SE, Fan J
Pediatr Surg Int 2010 Apr;26(4):393-9. Epub 2010 Feb 4 doi: 10.1007/s00383-010-2550-4. PMID: 20130887Free PMC Article
Arthroscopic treatment of internal rotation contracture and glenohumeral dysplasia in children with brachial plexus birth palsy.
Kozin SH, Boardman MJ, Chafetz RS, Williams GR, Hanlon A
J Shoulder Elbow Surg 2010 Jan;19(1):102-10. doi: 10.1016/j.jse.2009.05.011. PMID: 19664938

Clinical prediction guides

Shoulder Motion Overestimated by Mallet Scores.
Lovette M, Chafetz RS, Russo SA, Kozin SH, Zlotolow DA
J Pediatr Orthop 2024 Nov-Dec 01;44(10):e951-e956. Epub 2024 Jul 22 doi: 10.1097/BPO.0000000000002775. PMID: 39034600
Effect of arthroscopic shoulder release on shoulder mobility and bone deformity following brachial plexus birth injury: a systematic review and meta-analysis.
Massamba Vuvu T, Dorniol M, Le Nen D, Thépaut M, Brochard S, Pons C
J Shoulder Elbow Surg 2021 Oct;30(10):2428-2437. Epub 2021 Feb 7 doi: 10.1016/j.jse.2020.12.021. PMID: 33567353
Shoulder internal rotation contracture in brachial plexus birth injury: proximal or distal subscapularis release?
Allard R, Fitoussi F, Azarpira MR, Bachy M, Grimberg J, Le Hanneur M
J Shoulder Elbow Surg 2021 May;30(5):1117-1127. Epub 2020 Aug 25 doi: 10.1016/j.jse.2020.08.001. PMID: 32853791
Meta-analysis of function after secondary shoulder surgery in neonatal brachial plexus palsy.
Louden EJ, Broering CA, Mehlman CT, Lippert WC, Pratt J, King EC
J Pediatr Orthop 2013 Sep;33(6):656-63. doi: 10.1097/BPO.0b013e3182a11f0f. PMID: 23872798
Mobility and stability adaptations in the shoulder of the overhead athlete: a theoretical and evidence-based perspective.
Borsa PA, Laudner KG, Sauers EL
Sports Med 2008;38(1):17-36. doi: 10.2165/00007256-200838010-00003. PMID: 18081365

Recent systematic reviews

Effect of arthroscopic shoulder release on shoulder mobility and bone deformity following brachial plexus birth injury: a systematic review and meta-analysis.
Massamba Vuvu T, Dorniol M, Le Nen D, Thépaut M, Brochard S, Pons C
J Shoulder Elbow Surg 2021 Oct;30(10):2428-2437. Epub 2021 Feb 7 doi: 10.1016/j.jse.2020.12.021. PMID: 33567353
Arthroscopic Superior Capsular Reconstruction for Massive, Irreparable Rotator Cuff Tears: A Systematic Review of Modern Literature.
Catapano M, de Sa D, Ekhtiari S, Lin A, Bedi A, Lesniak BP
Arthroscopy 2019 Apr;35(4):1243-1253. Epub 2019 Mar 14 doi: 10.1016/j.arthro.2018.09.033. PMID: 30878327
Meta-analysis of function after secondary shoulder surgery in neonatal brachial plexus palsy.
Louden EJ, Broering CA, Mehlman CT, Lippert WC, Pratt J, King EC
J Pediatr Orthop 2013 Sep;33(6):656-63. doi: 10.1097/BPO.0b013e3182a11f0f. PMID: 23872798
Supportive devices for preventing and treating subluxation of the shoulder after stroke.
Ada L, Foongchomcheay A, Canning C
Cochrane Database Syst Rev 2005 Jan 25;2005(1):CD003863. doi: 10.1002/14651858.CD003863.pub2. PMID: 15674917Free PMC Article

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