Any patient with a suspected acute rotator cuff tear or with significant disability should receive prompt referral to an orthopaedist within 7 days. Young patients with full-thickness rotator cuff tears usually require surgical repair. Functional results are better if repair is carried out within 3 weeks of injury, before retraction, fibrosis, tendon degeneration, and muscular atrophy have occurred. Partial thickness or chronic tears may respond to conservative measures; however, early referral is warranted. If symptoms are improving at follow-up, conservative measures with physical therapy may be initiated. If significant symptoms and dysfunction persist, additional evaluation by MRI or CT arthrography may be pursued to determine the full extent of injury.
Following acute injuries, any evidence or suspicion of neurovascular compromise requires immediate orthopaedic consultation.
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