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

G. Walch, MD

Clinique Orthopédique Emilie de Vialar, 116 Rue Antoine Charial, 69003 Lyon, France.

A. Boulahia, MD

220 Avenue Paul Santy, 69008 Lyon, France.

S. Calderone, MD

Via Terra Santa 93, 90141 Palerme (PA), Italy.

A. H. N. Robinson, FRCS

Department of Orthopaedics, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK.

Correspondence should be sent to Dr G. Walch.

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.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General