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548 Infraspinatus Tendon Disorders

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Dist 3.85 cm
Dist 1.16 cm 4.0
RT INFRASPINATUS
INFRASPINATUS TENDON DISORDERS Transverse ultrasonogram of an acute infraspinatus injury. Note
the normal architecture in the top of the image, contrasting with the disrupted architecture outlined by the
white crossmarks.

Chronic Treatment PEARLS & CONSIDERATIONS
INFRASPINATUS TENDON DISORDERS Charac- Infraspinatus contracture treatment consists
teristic limb positioning of a dog with left infraspinatus of infraspinatus (and sometimes teres minor) Comments
contracture. (Courtesy Kathleen Linn.) tenotomy and excision of the tendon inser- • Contracture of the infraspinatus or teres
tion. Immediate ability to pronate the limb is minor muscles, or both, produces the
achieved. Leash walks are performed imme- characteristic gait abnormality.
diately postoperatively, and normal activity • Lifting the dog’s front end off of the ground
TREATMENT is resumed 10-14 days after infraspinatus or examining the dog in lateral recumbency
tenotomy. with the affected limb on the nondependent
Treatment Overview side highlights the external rotation of the
Surgical treatment is usually indicated for infra- Nutrition/Diet distal limb.
spinatus contracture, with the goal of returning Dietary management to prevent or treat obesity
normal range of motion to the affected limb. is likely beneficial for long-term management. Technician Tips
Conservative therapy may be chosen because • Early passive range of motion after tran-
the contracture does not appear to be painful, Behavior/Exercise section of the infraspinatus tendon speeds
but this strategy is unlikely to resolve the gait • Exercise is restricted for 2-4 weeks after recovery and prevents recurrence.
abnormality. surgery. Physical therapy with passive • It is essential to cycle the shoulder rather than
range-of-motion exercises and walking are the entire limb; have clients demonstrate the
Acute General Treatment recommended as soon as possible after technique back to you after teaching them
• If acute infraspinatus trauma is suspected, surgery to aid the return of normal range to ensure optimal compliance.
early fasciotomy (with suturing of the muscle of motion.
tear) may be indicated to decompress the • Surgical treatment for infraspinatus contrac- SUGGESTED READING
muscle and avoid compartment syndrome. ture usually returns the dog to full function. Devor G, et al: Fibrotic contracture of canine infra-
However, the acute phase often goes spinatus muscle: pathophysiology and prevention
unrecognized. Possible Complications by acute surgical intervention. Vet Comp Orthop
• Injection of platelet-rich plasma (PRP) with • Seroma Traumatology 19:117-121, 2006.
ultrasound guidance into affected areas of • Infection AUTHOR: Peter Gilbert, BVSc, MVetSc, DACVS
the tendon and muscle shows promise if • Persistent lameness and restricted range of EDITOR: Kathleen Linn, DVM, MS, DACVS
early acute injury can be detected. Con- motion
trolled clinical studies are lacking at this
point. PROGNOSIS & OUTCOME
• Physical rehabilitation may be successful in
maintaining range of motion and preventing Surgical treatment of infraspinatus contracture
fibrotic contracture in acute cases. usually leads to an excellent outcome.

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