Shoulder trauma is a major cause of osteoarticular trauma. Indeed, Rambert in France reported 54.34% of shoulder trauma cases, Kocher and Feagin in the USA 11.2%, Diarra in Mali 9.73%, and Ouédraogo in Burkina Faso 6.73% [1][2][3][4]. Several types of shoulder trauma have been identified, dominated by fractures and dislocations. In addition to bone and joint injuries, there are also post-traumatic tendon injuries, notably to the rotator cuff. Rutten et al. in the USA found 46% cases of rotator cuff lesions in non-fractured shoulder trauma, Rambert in France 41%, and Kocher and Feagin 25% [1][2][5]. In our context, the diagnosis and management of shoulder trauma most often focus on fractures and dislocations, as shown by studies by Badr in Morocco, Diarra in Mali, and Ouédraogo in Burkina Faso [3][4][6]. Post-traumatic shoulder treatment aims to reduce, consolidate, and above all, recover shoulder function. This is generally not possible without diagnosis and management of tendon and ligament injuries, requiring MRI or ultrasound. Ultrasound offers comparable results to MRI at a much lower cost and can detect discrete abnormalities and several different tendon pathological entities [7-8]. In Africa, however, there is very little demand for this procedure in the management of shoulder trauma. Indeed, in a study carried out by Badr in Morocco, it was performed in 2.4% of cases, and no ultrasonography was performed in the studies by Diarra in Mali and Ouédraogo in Burkina [3][4][6]. We therefore proposed to study ultrasound lesions of the rotator cuff in cases of non-fracture shoulder trauma at the CHUYO in Ouagadougou.

We documented 30 cases of shoulder trauma, including 20 cases of rotator cuff injury (66.67%), 36.67% of which were tendon ruptures. Our results are similar to those of Rambert [1] and Rutten [5]et al., who reported 34% and 46% cases of rotator cuff tendon damage respectively.

The mean age of patients with cuff lesions was 27.6 years. Of the 11 patients with tendon ruptures, 63.63% were young adults under 35 years of age and 27.27% were adults over 35 years of age. Our results are similar to those of Flurin [14] (26.7 years), Kocher et al. [2], and Kaplan et al. [9], who found an average age of 25 years. However, this differs from Badr [6], who found that 66.66% of cuff tears were over 36 years of age. Other authors have also reported a higher mean age. Mall et al. [10] and Walcott et al. [11] reported mean ages of 54.7 and 47.9 respectively. Rotator cuff tears in young adults are most often associated with violent trauma, such as the direct impact on the shoulder stump, falls with the arm abducted and sports accidents [11][12]. In an older population, cuff injuries most often occur following moderate trauma to an already weakened cuff, according to the literature [11][12][13][14].

The male sex was the most represented, with a sex ratio of 3. Our results are comparable to those of Badr [6] who reported a sex ratio of 3, Ouédraogo [4] where it was 3.02, and Seidou [15] where it was 2.09. This finding can be explained by the fact that men engage in risky behaviors and activities that expose them more to accidents.

The circumstances in which trauma occurred were dominated by road traffic accidents (60%). Ouédraogo [4] noted that 73% of patients were victims of traffic accidents. This could be explained by the increase in the number of vehicles on the road in recent years.

Ultrasound was normal in 7 cases. No additional Magnetic Resonance Imaging (MRI) was performed in our series. Rutten et al. had noted 2 cases of normal ultrasound; these were confirmed by additional MRI [5]. In the literature, ultrasound findings are often comparable to those of MRI [7][16][8].

Tendon ruptures were the most frequent rotator cuff lesions (36.67%), followed by tendinitis (23.34%) and tendon disinsertion (10%). Rambert [1] found the same order of frequency, with 34% of tendon ruptures, 7% of tendinitis and 0% of tendon disinsertion. Rutten et al. found 46% tendon ruptures [5]. According to the literature, tendon ruptures are the most frequent form of rotator cuff injury [7][16].

Pathological images of the rotator cuff included hypoechoic and anechoic tendon defects, hypoechoic tendons without associated defects, tendon thickening, loss of tendon fibrillation, tendon vascularization on Doppler and tendon flattening. Our results corroborate those reported in the literature [7][17][16][18].

Non-transfixing ruptures were the most common in our series, accounting for 91% of cases versus 9% of transfixing ruptures. Rambert found 58% non-transfixing ruptures and 42% transfixing ruptures [1], while Rutten et al. reported 57% transfixing ruptures and 43% non-transfixing ruptures [5]. Lesions depend on the severity of the impact and/or the condition of the tendon.

In our study, the supraspinatus was most affected (81.81% of cases). Our high rates of supraspinatus involvement are in line with the literature [8][13][19][16].

Of our 20 patients with rotator cuff damage, radiographs were normal in 90% of cases. All patients with rotator cuff damage in Rambert's study [1] had normal radiographs. Clinicians' spontaneity in requesting standard radiographs is linked to the fact that, in trauma cases, there is a tendency to look mainly for bony lesions. However, systematic ultrasound can show traumatic lesions on normal radiographs, as demonstrated in our study and in those of Rambert [1] and Rutten et al. [5].

Ultrasound plays a vital role in the diagnosis of rotator cuff injuries in shoulder trauma in our context. These lesions are frequent and dominated by tendon ruptures, tendinitis, and deinsertions. Trauma to the shoulder occurs mainly in young adult males, and the main cause is road traffic accidents. Standard X-rays, which are indispensable in traumatology, are sometimes limited in the case of shoulder trauma, hence the importance of ultrasound. To improve patient care, ultrasound should be more widely prescribed for shoulder trauma. Ultrasound is almost as sensitive as MRI, so in our context, MRI should be reserved for cases of symptomatic shoulder trauma with normal radiography and ultrasound.