Traumatic tear of the rotator interval.

We studied 10 patients with capsular tear of the glenohumeral joint in the rotator interval -- the triangular space separating the supraspinatus and subscapular tendons. The patients, manual laborers and athletic people, had no previous shoulder pain. Tears appeared after forced internal rotation caused by trauma. The pain was anterior and radiated distally. Pain was absent at rest but recurred immediately after activity was resumed. On examination, range of motion was normal. Hawkins' impingement sign and the palm-up test usually caused pain. Radiographic findings were normal. Arthrography showed leakage of contrast medium into the subscapularis fossa. The tear was not visualized with ultrasonography or magnetic resonance imaging. Eight patients underwent an operation consisting of minimal acromioplasty with coracoacromial ligament resection, coracoidplasty, and suture of the rotator interval. All patients had relief of pain and return of full function.