Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Nov 18, 2020; 11(11): 516-522
Published online Nov 18, 2020. doi: 10.5312/wjo.v11.i11.516
Treatment of a rotator cuff tear combined with iatrogenic glenoid fracture and shoulder instability: A rare case report
Chen-Hao Chiang, Ting-Chien Tsai, Kuan-Kai Tung, Wei-Hsing Chih, Ming-Long Yeh, Wei-Ren Su
Chen-Hao Chiang, Ming-Long Yeh, Department of Biomedical Engineering, National Cheng Kung University, Tainan 70428, Taiwan
Chen-Hao Chiang, Ting-Chien Tsai, Wei-Hsing Chih, Department of Orthopaedic Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan
Kuan-Kai Tung, Department of Orthopaedic Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Wei-Ren Su, Department of Orthopaedic Surgery, National Cheng Kung University Hospital, Tainan 70428, Taiwan
Author contributions: Chiang CH conceived the designed the study, acquired data, and wrote the original draft; Chiang CH, Tsai TC, and Tung KK analyzed and interpreted the data; Chiang CH, Tsai TC, and Chih WH provided the resources for the data; Yeh ML provided the methodology and validation of the case; Tsai TC, Chih WH, Yeh ML, and Su WR were supervisors for this draft; Tung KK reviewed and edited the draft; All authors have read and approved the final manuscript.
Informed consent statement: Informed consent was obtained from the patient, and she gave permission for her case to be published.
Conflict-of-interest statement: The authors declared that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ting-Chien Tsai, MD, Surgeon, Department of Orthopaedic Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, No. 539 Zhongxiao Road, East District, Chia-Yi 60002, Taiwan.
Received: March 2, 2020
Peer-review started: March 2, 2020
First decision: September 11, 2020
Revised: September 22, 2020
Accepted: October 9, 2020
Article in press: October 9, 2020
Published online: November 18, 2020

The brisement manipulation is an effective treatment for refractory shoulder stiffness. Rotator cuff tears can sometimes exist in combination with adhesive capsulitis. Arthroscopic capsular release combined with rotator cuff repair has achieved good outcomes in published reports.


We report the case of a patient with right shoulder pain for more than 1 year that was suspected to have adhesive capsulitis and a rotator cuff tear that was treated with brisement manipulation and arthroscopic management. An iatrogenic glenoid fracture with shoulder instability occurred during the manipulation. Arthroscopic treatment for fracture fixation, capsular release, and rotator cuff repair was performed, and the functional results are reported.


Arthroscopic fixation for iatrogenic glenoid fracture and repairing coexisting rotator cuff tear can provide the stability needed for early rehabilitation.

Keywords: Frozen shoulder, Bursitis, Arthroscopy, Fracture, Glenoid fracture, Manipulation, Iatrogenic, Case report

Core Tip: Manipulation under anesthesia is an effective treatment for refractory stiff shoulder, but some severe complications have been reported. We present a rare case of rotator cuff tear and antero-inferior glenoid rim fracture combined with shoulder instability after manipulation for shoulder stiffness. Arthroscopic repair of the glenoid fracture and concomitant rotator cuff tear was performed. A good outcome was achieved with this treatment in the 2-year postoperative follow-ups.