Fosbury flop tear of the rotator cuff

Last revised by Ryan Thibodeau on 13 Oct 2023

Fosbury flop tears of the rotator cuff are full-thickness rotator cuff tears with a reversed superomedial or flipped orientation of the torn tendon stump.

Fosbury flop tears are uncommon with a prevalence of ~2.5% of all rotator cuff tears 1-3.

The diagnosis is suggested by typical features on MRI or MR arthrography and can be confirmed arthroscopically.

The Fosbury flop tear has been characterized as an avulsion injury of the posterosuperior rotator cuff with reversed healing on the bursal side.

A reverse variant Fosbury flop tear pattern with the tear at the musculotendinous junction flipping anterolaterally onto the anterior humerus and coracoid process has been described 2.

The following five radiological abnormalities have been described on MR arthrography 1-3:

  • thickened tendon (>9 mm)
  • tendon stump
  • abnormal fiber orientation
  • fluid accumulation in the superomedial portion of the subacromial bursa
  • adherence between the bursal side of the supraspinatus tendon and subacromial bursa

The radiology report should include the following features:

  • tear pattern including the following
    • full-thickness/partial-thickness
    • thickened supraspinatus tendon
    • abnormal fiber orientation
    • tendon stump
  • tear dimensions
  • muscle atrophy, fatty degeneration

Treatment is usually surgical and failure to recognize the tear type will usually lead to non-anatomic repair or failure to repair 3.

The Fosbury flop tear was named by Alexandre Lädermann and colleagues in 2015 after the jumping style in the track and field discipline high jump 1.

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