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

J Bone Joint Surg Br. 1998 Jul;80(4):624-8. doi: 10.1302/0301-620x.80b4.8651.


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.

MeSH terms

  • Activities of Daily Living
  • Adipose Tissue / pathology
  • Aged
  • Aged, 80 and over
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Hypertrophy
  • Male
  • Middle Aged
  • Muscle, Skeletal / pathology
  • Muscular Diseases / pathology
  • Range of Motion, Articular / physiology*
  • Rotation
  • Rotator Cuff / physiopathology
  • Rotator Cuff / surgery
  • Rotator Cuff Injuries*
  • Rupture
  • Sensitivity and Specificity
  • Shoulder / pathology
  • Shoulder Joint / physiopathology*
  • Treatment Outcome