Table Of ContentDisorders 
oft he 
Shoulder 
Diagnosis and Management.· 
Sports Injuries 
THIRD  EDITION
VOLUME  2 
Disorders 
oft he 
Shoulder 
Diagnosis and Management: 
Sports Injuries 
THIRD  EDITION 
VIIWIII! I!DII'III 
Anthony Miniaci, MD, FRCSC  _., ........~ ~. IIIJ:K 
---
.-..~.1 -1.'-Dii_lf,... 
-m• 
Profeuor of S\11181Y 
-
CIMiend Clinic Lerner College of Medi~ine  _ 
CIMiand Clinic  -............. ..  ...l.o.,M D 
Garfield Heiahta. Ohio  ...... ,no : •  ...., 
... 
~ 
---"-"~;:: :_ 
Ellii'OII  ......... tw:4J:MI 
....... D.lldaw•MD 
_...   .... 
..._-..._~.~... l.o.,o .i..O.I ,I., I.ti.......l.ic ,. wPII D  l_llfB_IM._•.t.rr. e, _a _• ... ....., ,. , 
.... 
...  ..... 
- · 
c..~-..- -"tlllotu..--.t.p.~~ 
....... 
r-~.. ~ 
lla.O...fallr.--
I 
•  W.-...o..l-.r ers- K-lu-w-er -L-ipp-incott WIWams & Wilkins 
ft.ll-'•:1••' a  , ..... •NM'ttlrlr•~
Acquisitii»>S EditfJr: Brian Brown 
PriJ~rtMflnllger: Dave Murphy 
PrfJ~ctifJn ManAger: David Sahzberg 
Marlteting ManAger: Lisa Zok.s 
Manuffl&turing ManAger: Beth Welsh 
Design Manager: Stephen Druding 
ProductifJn Services: Integra Software Services Pvt. Ltd. 
Printer: RR Donnelley Asia 
© 2014 by llppincott Williams & Wilkins, a Wolters Kluwer Business 
Second edition © 2007 by llppincott Williams and Wilkins 
First edition © 1999 by llppincott Williams & Wilkins 
351 West Camden Street  Two Commcn:e Square 
Baltimore, MD 21201  2001 Market Street 
Philadelphia, PA 19103 USA 
Printed in China 
All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted 
in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any 
information storage and retrieval system without written permission from the copyright owner, except for brief 
quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals 
as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. 
To request permission, please contact Lippincott Williams & Wllkins at 2001 Market Street, Philadelphia, PA 
19103, via email at [email protected], or via website at lww.com (products and services). 
Libnuy of CoDgRA Cataloging-in-Pabllauion Data 
Disorders of the shoulder: diagnosis & management. - Third edition. 
P· ;em. 
Prcccded by: Disorders of the shoulder I editors, Joseph P. Iannotti, Gerald R. Williams Jr. 2nd cd. c2007. 
2 v. (xii, 1364, 1-42 p.). 
Includes bibliographical references and index. 
ISBN 978-1-4511-2745-4 (v. 1)-ISBN 97S.1-4511-3058-4 (v. 2)-ISBN 978-1-4511-3057-7 (v. 3) 
I. Iannotti, Joseph P., editor of compilation. II. Williams, Gerald R., Jr., 1958-editor of compilation. 
III. Miniaci, Anthony, editor of compilation. N. Zuckerman, Joseph D. Ooseph David), 1952-editor of 
compilation. 
[DNLM: 1. Shoulder-surgery. 2. Athletic Injuries-diagnosis. 3. Athletic Injuries-surgery. 4. Joint 
Diseases-diagnosis. 5. Joint Discascs-sur~ry. 6. Shoulder Joint-sur~. WE 810] 
RD557.5 
617.5 '72----dc23 
2013020790 
Care has been taken to confirm the accuracy oft he information present and to describe generally accepted 
practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any 
consequences from application of the information in this book and make no warranty, expressed or implied, 
with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this 
information in a particular situation remains the professional responsibility of the practitioner; the clinical 
treatments described and recommended may not be considered absolute and universal recommendations. 
The authors, editors, and publisher have aened every effon to ensure that drug selection and dosage set 
forth in this text are in accordance with the current recommendations and practice at the time of publication. 
However, in view of ongoing research, changes in government regulations, and the constant £low of information 
relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any 
change in indications and dosage and for added warnings and precautions. This is particularly important when the 
recommended ~nt is a new or infrcquendy employed drug. 
Some drug~ and medical devices presented in this publication have Food and Drug Administration 
(FDA) clearance for limited usc in restricted research settings. It is the responsibility of the health care provider 
to ascenain the FDA status of each drug or device planned for use in their clinical practice. 
To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders 
to (301) 223-2320. International customers should call (301) 223-2300. 
Visit Lippincott Williams & Wilkins on the Internet http://www.lww.com. llppincott Williams & Wilkins 
customer service representatives arc available from 8:30 am to 6:00 pm, EST.
Dedication 
To my clinical and research colleagues, the students, residents, fellows, and 
my patients who together taught me all that I know about the shoulder and 
all that I will learn in the future. 
-joseph P. Iannotti 
To my parents Joe and Lina Miniaci, for the struggles, sacrifices, and risks 
that they endured to make a better life for their family. To my children Sara 
Lyn, Joseph, and Anthony, who have been a parent's dream and have always 
been there for me and shown an interest in what I did in my time away from 
home. And most of all to my wife Judy, my best friend and the love of my life; 
she has made anything we have ever accomplished possible. 
-,Anthony Miniaci 
I would like to dedicate the third edition of Shoulder Disorders to my patients, 
teachers, and students-past, present, and future-without whom this book 
would not be possible. In addition, I would like to thank Joe Iannotti for 
his friendship and mentoring over the years. Thanks also to Joe Zuckerman 
and Tony Miniaci for joining us on this project-it is vastly better because 
of you. Thanks to Bob Hurley and staff at Lippincott who have pushed us to 
finish this project. Finally, I would like to thank my wife, Robin, and my two 
children, Mark and Alexis, for their love and understanding. 
-Gerald R  WiUiams, Jr. 
To my wonderful family-to my truly special wife Janet and my outstanding 
sons Scott and Matthew-you have  been  and  always  will  be  the  most 
important and meaningful parts of my life. 
-joseph D. Zuckerman
CONTENTS 
-0.-
9 
eAni_tAmt_. rSiumld.r~c 
llq>eir  150 
.III!ID!I."-I!r"""a. ...  HllGI 
PAn 1: 
IAtrocJII':doe  1 
11 
~1-biliry.~ 
1  P.•• ""' • 
Th.e .Ad!L:u'o Sb.aulda:: lilj wy  lltp<in  174 
:&1M!. £v.ai1Wioll  3 
>1-n-t-
a..e. 
1  12 
MultldlrcaiDmllllotah!l.tty  191 
r.ro.H.-In-~ 'lift Slot 
13 
klaado.o. aAd a...ilicalioo of llallcd 
I4am0l>1ilil-:yP L:.p-.ait  198 
3  '"''tP"i 
eolfi. c.h e Sports IDjury: lndinrrio'll  Hat....._lllltw~.bltlM.AJ.stl'lllb\MctwdC.,....,, 
""" Fin  31 
IWV'*r'fM.jW\OW!nMo.-.MIWI~ni.WWN.P'Il* 
15  S"''Jical 
Ma•av"'CIIC of lootabilil:y with 
B_o,,.a,I.cI> L,o.t .o.. .  228 
AI<1ho!t_ 
16 
Suqpml M•""V"'""' ofG  leo.olwmenl 
IDnslhilil:y with s..ft.T..., 
l>dkimoy  2SS 
PAn II: 
Mlr1A.Min41dlhlilD.O.W 
Glm!ohuu•nllalabil.il.y 
mdlahtai.T- 91 
- tAIT Ill: 
6 
Sboulder Inm.billty: Cb.-i6calioa 
:Rotator CaS' ad Bic:cpll Tcadoa.  26S 
93 
an.!D~ 
.. 
-'"'""'"-
17 
-,.- RDmr.rOalfT""" a..,.;Sarioa 
7 
SLAPT..,.,D'iasn..;.....t  mel D'iagu,.;,  2t ll 
Man•p.....,.t   11, 
-~-
-~- 11 
a  &oa.mrc..!Fitq>alr: Ope 
~ &boulda loolabilil:y---Opo:A  Man'P"mt  280 
m 
1lqoairo 
-.s.-n~~-
'1l!6!1~"""' ~oil Hol.ti"'*U _..,. 
m
~~ CONTENTS 
19  Rotator Cuff Repairs: Arthroscopic  PART  VI: 
Management  291  Glenohumeral Arthritis  423 
Stephen S. Burkhart and PatrickJ. Denard 
27 
20  Early Arthritis in the Athlete: Management 
Massive CuffTears: Open and Arthroscopic 
Approaches  425 
Approaches  325 
Kevin D. Plancher. Francesca M. Swartz. and Stephanie C. Petterson 
Umasuthan Srikumaran, Tyler Fox, laurence D. Higgins, 
and Jon J.P. Warner 
21 
The Biceps Tendon Complex  344 
PART  VII: 
Pascal Boileau and Jason Old 
Neurovascular Disorders  439 
PART  IV:  28 
Diagnosis and Management 
Muscle and Tendon Ruptures  371  of Neurovascular Disorders About 
the Shoulder in the Athlete  441 
22 
Pectoralis Major Rupture: Diagnosis and  Bill Bragg, Emilie Cheung, and Marc R. Safran 
Treatment  373 
Frank A. Cordasco and De metris De los 
23  PART VIII: 
Diagnosis and Management of Latissimus 
Dorsi, Teres Major, Pectoralis Minor, Shott  Sport~Specific Disorders  469 
Head Biceps/Coracobrachialis, Triceps and 
29 
Ddtoid Tendon Ruptures  381  Common Shoulder Injuries Associated 
John Zouzias and William N. Levine  with Tennis and Baseball  471 
Christopher C. De dson and David W. Altchek 
30 
Swimming Injuries in the Shoulder  481 
PART  V: 
Klaus Bak 
Acromioclavicular Joint Injuries  389 
31 
Common Shoulder Injuries in Hockey and 
24 
Acromioclavicular Joint Pathology:  American Football  488 
Evaluation, Biomechanics,  Gordon W. Nuber. T. Sean Lynch. Matthew D. Saltzman. and 
Sara L. Edwards 
and Classification  391 
32 
Karl F. Bowman. Jr. • and Mark W. Rodosky  Common Shoulder Injuries in 
25  Volleyball  510 
Arthroscopic Treatment for 
KN Subramanian and Peter B. MacDonald 
Acromioclavicular Joint Injuries  402 
33 
Micah C. Hobbs. William H. Paterson. Sumant G. • Butch" Krishnan,  Shoulder Injuries in Skdetally Immature 
and Wayne Z. Burkhead, Jr. 
Athletes  526 
26 
Open Treatment of Acromioclavicular  Daryl C. Dsbahr, Samue I A. Taylor. and James R. Andrews 
Injuries  409 
Cory M. Edgar, Knut Beitzel. Robert A. Arciero. and Augustus D. Mazzocca 
Index  545
: ~ gn
 
c c:e
;
 
  U  
  lJ!
l
   fj fj
f {  f 
 
t.    f~f I 
    !  I  fltfl j 
 '  n ,,  Jftlf
f
{   
f   !i:
! ;  hf f ~{ 
  n ~t
r  f f  I  UifU
Ul .   
~. 
  !
I ff
(,
 
l f~!
  i    f r
f f llf  ~ ,, HI1ifl 5 J 
  J   r' 
f ~  r
   
{  i f. ~
I . i
J    Ufiti   
  ~ ; f ~
 r ~ f   •f,
J '.   ~   tJ  
! ~ ~..
H~  
l  
 U ~fl
  .
f  
U Q l~~
 
l~
H   J 
f !
    lI  liJ  
  U fr-f
l f nf '
'
J    
  i '"'  
   JlU rr1'i lJ
lf    r
f ~     
i ~, !l~I
f- t ~, il
 i f ~ ff
rr  d  ~  HfJ~ 1 
~   Q f· 
   l   n[ t
Jr f J  d
' '
! r1t  
  i I  1  j
i r
r
 
1
£