Posterior shoulder dislocation (PSD) is a rare injury with an incidence rate of approximately 1.10 per 100,000, accounting for only 2% to 5% of all types of shoulder dislocations. Coupled with its lack of typical symptoms and imaging manifestations, the rate of missed diagnosis at the initial diagnosis is as high as 60% to 79%. Therefore, it is rare in clinical practice and highly challenging in clinical diagnosis and treatment. PSD is often caused by direct or indirect high-energy violence such as car accidents, epileptic seizures, and electric shocks. PSD is frequently accompanied by proximal humeral fractures (PHF). PHF can be classified into six types according to the Neer classification, and the higher the number, the more severe the injury. Among them, Neer typeⅥ is usually accompanied by humeral head fragmentation, bone defect, and severe rotator cuff injury. If PSD combined with Neer typeⅥ PHF is not diagnosed and treated in time, it can easily cause shoulder joint pain, stiffness, shoulder deformity, limited movement, shoulder instability, etc. Over time, it may lead to humeral head necrosis due to a blood circulation disorder. Currently, for patients with Neer typeⅥ PSD-PHF, open reduction and internal fixation treatment should be performed. The goal is to achieve anatomical reduction, stable fixation, and early functional exercise. Although clinical reports on patients with simple PHF are not uncommon at present, for patients with the special type of PSD-PHF, such as "fracture - dislocation", due to the small number of cases and the difficulty of intraoperative reduction, there is still a lack of strong evidence-based medical basis for the selection and operation of surgical methods in clinical practice at present.

To explore the diagnosis and treatment methods of posterior shoulder dislocation combined with proximal humerus fractures (PSD-PHF) .

A retrospective analysis was conducted on six patients with PSD-PHF fractures, classified as typeⅥ by Neer, in our hospital from April 2020 to December 2023. The expanded deltoid groove approach of the pectoralis major muscle was adopted. The dislocated humeral head and joint capsule were exposed, the incarcerated biceps brachii tendon or rotator cuff was released, the humeral head was pried and reduced under direct vision, and each fracture fragment was reduced successively. First, lock the bone plate for fixation. If necessary, hollow screws or bundled cables can be used to enhance the fixation. When combined with the anti-Hill-Sachs injury with an anterior edge loss area of the humeral head reaching 25% to 50%, artificial bone is implanted at the bone defect site under the humeral head to provide support. Finally, suture anchors are used to repair the torn subscapularis muscle and supraspinatus tendon in sequence. Compare the visual analogue scale (VAS) for pain before the operation and the University of California- Los Angeles shoulder function scoring system at the last follow-up after the operation. UCLA score and shoulder joint range of motion.

The surgeries of all six patients with PSD-PHF in this group were completed. The operation time ranged from 50 to 80 minutes, with an average of (65.00±6.42) minutes. The hospital stay ranged from 8 to 29 days, with an average of (11.20±1.59) days. All patients were followed up for more than 12 months. The follow-up period ranged from 12 to 20 months, with an average of (14.30±1.67) months. Bony union was achieved in all 6 fractures, with an average healing time of (5.04±0.62) months. There was no loosening or prolapse of internal fixation. At the last follow-up, the VAS score of the patients was (1.00±0.21) points, which was lower than that before the operation [ (8.00±1.30) points] (P<0.001). The UCLA score was (32.53±1.04) points, which was higher than that before the operation (9.08±1.52) points (P<0.001). Among them, there were 4 cases of excellent, 1 case of good, and 1 case of poor, and the excellent and good rates were 83.33% (5/6). Shoulder joint activity: proneness (138.85+ 18.67) °, outreach (128.69-10.57) °, outside screw (48.61 + 2.28) °, were greater than preoperative (60.14+ 7.21) °, (40.87-4.26) °, ° [- (29.85 + 3.18) ] (P< 0.001) .

Patients with Neer typeⅥ PSD-PHF are relatively rare in clinical practice. Early diagnosis and early surgery can promote fracture healing, relieve pain, improve shoulder joint function, and restore shoulder joint range of motion in patients.

Rotator cuff tear is a common condition of the shoulder joint. For patients who do not respond to conservative treatment, arthroscopic rotator cuff repair surgery becomes the main treatment option. However, retearing after rotator cuff suture remains a significant challenge for surgeons. This article describes a new technique for arthroscopic rotator cuff repair: the "Cable bridge" suture technique. Based on the suture principle of a cable bridge, this technique forms an integral structure by interlocking the different knots of the inner and outer rows of anchor nails.

To introduce an improved arthroscopic suture bridge technique for rotator cuff injury repair (Cable bridge), evaluate the clinical effect of this technique in rotator cuff injury repair, and conduct a comparative analysis with the traditional suture bridge technique.

The research protocol adopted a prospective controlled design. Patients with moderate or large rotator cuff injuries were selected as research subjects and randomly assigned to the observation and control groups for comparative analysis. In this study, the observation group received the "Cable bridge" technique, while the control group used the traditional suture bridge method. The system analyzed and recorded index data from the surgical process and the occurrence of complications in the two subject groups. The VAS, Constant, UCLA, and ASES scores of the two groups of subjects at each time point before and after the operation were compared and analyzed. Meanwhile, shoulder joint range of motion changes in the two patient groups at 6 and 12 months after the operation were evaluated, and the rotator cuff retear rate at 12 months was further tracked.

A total of 87 patients were included in the study, including 48 in the observation group and 39 in the control group. Data analysis revealed no significant differences between the two groups in operation duration, intraoperative blood loss, or postoperative hospital stay (P>0.05). During the operation and in the early postoperative period, no adverse events, such as vascular or nerve injury, wound infection, or anchor detachment, were observed. In the postoperative assessment, compared with those before the operation, the pain VAS scores of both groups of patients decreased significantly (P<0.05), and during the 3-month, 6-month, and 12-month follow-up periods, all related indicators, such as Constant, UCLA, and ASES scores, showed a continuous improvement trend (P<0.05). During the 6- and 12-month follow-up periods after the operation, forward flexion and external rotation range of motion of the shoulder joint in both groups increased significantly, showing noticeable improvement compared with preoperative values (P<0.05). At the 12-month follow-up after the operation, the incidence of rotator cuff retear events in the observation group was only 6.25%, while that in the control group was 20.51%. There was a statistically significant difference between the two groups of data (P<0.05) .

For the repair of medium and large rotator cuff tears, both the arthroscopic "Cable bridge" technique and the traditional suture bridge technique can achieve good clinical efficacy and effectively restore shoulder joint function. Compared with the traditional suture bridge technique, the "Cable bridge" technique can reduce the risk of the rotator cuff retearing after surgery.

The rotator cuff is a complex of four tendons that wrap around the head of the humerus, consisting of the anterior subscapularis muscle, the superior supraspinatus muscle, the posterior supraspinatus muscle, and the teres minor muscle. It is named for its shape, resembling a sleeve, and is crucial for maintaining the function and stability of the shoulder joint. Rotator cuff tear is an important cause of shoulder pain and limited joint movement. It is often triggered by factors such as overuse of the shoulder and external trauma, which can lead to weakened elasticity of the muscle tissue and result in partial or full-thickness tears of the shoulder muscle structure. Among them, athletes who repeatedly perform shoulder activities over a long period, such as swimmers, tennis players, and shot put players, are prone to injuries due to excessive use of the shoulder joint and significant mechanical pressure on the rotator cuff. The elderly are also a high-risk group for this disease. As people age, the rotator cuff tendons undergo degenerative changes, and minor injuries or impacts may cause acute rotator cuff tears. In addition to causing pain around the shoulder, rotator cuff tears can also affect the quality of life of patients due to shoulder dysfunction and increase their self-perceived burden. Epidemiological studies have shown that the incidence of rotator cuff tears accounts for 14%-32% of shoulder diseases and increases with age. At present, arthroscopic rotator cuff repair is the mainstream surgical method for treating rotator cuff tears in clinical practice. It has the advantages of minor trauma, quick recovery, and few complications. It can minimize the damage to shoulder joint tissues and facilitate the repair of rotator cuff tissues. Most patients can achieve shoulder joint function that is close to normal after this surgery. However, postoperative pain in patients remains an urgent clinical problem to be solved. Patients often resist rehabilitation exercises due to shoulder pain, which not only affects the recovery of upper limb function but may also lead to complications such as muscle atrophy and shoulder adhesions. Although the commonly used drug analgesic method in clinical practice can relieve pain, due to the limited analgesic effect and the different tolerance of patients, it is difficult to achieve the ideal analgesic state, which affects rehabilitation compliance.

To explore the impact of shoulder pain management strategies after arthroscopic rotator cuff tear repair on early functional outcomes such as upper limb function and activities of daily living.

A total of 80 patients who underwent arthroscopic rotator cuff tear repair in our hospital from August 2022 to November 2024 were selected. The groups were grouped by the random number table method (random numbers ranging from 1 to 80 were generated by statistical software and assigned according to the order of admission. Odd numbers were included in the conventional group and even numbers in the management group. The conventional group received conventional analgesic intervention, while the management group implemented personalized multimodal analgesia + psychological intervention + stepwise rehabilitation training. The Fugmeyer upper limb motor function scale (FMA), the evaluation criteria of the American society for shoulder and elbow surgery (ASES) scoring system, the visual analogue scale (VAS) for pain, the range of motion of the shoulder joint, the modified Barthel index (MBI), and the rotator cuff healing conditions were compared between the two groups before the intervention and 3 months after the intervention.

After the intervention, the FMA and ASES scores of both groups increased compared with those before (P<0.05), and the FMA and ASES scores of the management group were significantly higher than those of the conventional group (P<0.05). Mild pain subgroup: The VAS scores of both groups dropped below 1 point, and there was no statistically significant difference between the groups (P>0.05). Moderate pain subgroup: The VAS score of the management group was significantly lower than that of the conventional group (P<0.05). In the severe pain subgroup, the VAS score of the management group was significantly lower than that of the conventional group (P<0.05). After the intervention, the ranges of motion of forward flexion, abduction, internal rotation, and external rotation of the shoulder joint in both groups were improved compared with before, and the improvement degree of shoulder joint motion in the management group was significantly better than that in the conventional group (P<0.05). After the intervention, the MBI scores of both groups increased compared with those before, and the management group was significantly higher than the conventional group (P<0.05). The re-tearing rate in the management group was 4.76%, significantly lower than 21.05% in the conventional group (P<0.05), and the number of cases classified by tear location in the management group was lower than that in the conventional group.

The application of shoulder pain management strategies for patients undergoing arthroscopic rotator cuff tear repair can significantly improve the function of the upper limb and shoulder joint, promote the recovery of shoulder joint range of motion, reduce the recurrence rate of tear, effectively relievePainn and enhance the ability of daily living, which is conducive to the early rehabilitation of patients.

Shoulder impingement syndrome is a common shoulder disorder characterized by a structural narrowing of the subacromial space, which causes pain when patients raise their arms or lie on the affected side. Current research suggests that preventing obesity can reduce the incidence of shoulder joint-related diseases, and obesity is positively correlated with rotator cuff ligament injury. Moreover, body mass index (BMI) can serve as a simple method to measure the degree of obesity, as it is easy to obtain and has clear categories. However, some studies suggest that a high BMI can have a specific protective effect on the shoulder joint. Therefore, the causal relationship between BMI and shoulder impingement syndrome awaits further study.

To explore the causal relationship between BMI and shoulder impingement syndrome by combining Mendelian randomization (MR) research method with bioinformatics analysis and analysis of the global burden of disease (GBD) database.

Based on the data of genome-wide association studies (GWAS) in European populations, BMI-related single-nucleotide polymorphisms (SNP) were screened as instrumental variables. The population burden was verified, and a regression model was constructed by combining five methods, including inverse variance weighted (IVW) with gene enrichment analysis and the GBD database.

A total of 390 cases of SNP were included. The analysis by five methods, including the inverse variance weighting method, showed that: For every 1-unit increase in BMI, the risk of shoulder impingement syndrome increases by 0.2% (OR=1.002, 95% CI: 1.001-1.003). Gene enrichment analysis suggests that BMI may influence shoulder impingement syndrome through the regulation of ion channels, synaptic signal transduction, and the Rap1 signaling pathway. Drug prediction has identified potential therapeutic drugs such as lorazepam and pilocarpine acid. GBD data analysis shows that a high BMI can increase the disability-adjusted life years for musculoskeletal diseases.

The research, from both genetic causality and population burden perspectives, confirmed that high BMI is an important risk factor for shoulder impaction syndrome, providing a theoretical basis for targeted intervention. However, further verification of racial universality and molecular mechanisms is needed.

Acromioclavicular joint dislocation (AC dislocation) is a common bone and joint injury in clinical practice, with an annual incidence rate of 18 per 10,000. It is more prevalent in men aged 20 to 39. Traffic accidents and sports activities are the main causes of the disease. The trauma mechanism is the injury of the coracoclavicular ligament caused by the direct or indirect stress transmission of the shoulder to the acromioclavicular joint. This then leads to dislocation of the acromioclavicular joint and the loss of its normal anatomical alignment structure. Most patients with acromioclavicular joint dislocation require surgical treatment. Currently, the main surgical methods are clavicular hook plate internal fixation and titanium plate internal fixation with loops. The clavicular hook plate is a classic surgical treatment method. Its principle is to restore the normal anatomical alignment of the acromioclavicular joint through open reduction, and then place the hook plate under the acromion. The upward displacement of the clavicular side is corrected and fixed through the lever principle. Based on the long-term follow-up results, Liu Zhenhuang, Zhou Haibing, Hu Yongbin et al. believe that the hook plate remains an effective surgical method for treating acromioclavicular joint dislocation. However, compared with other methods, the clinical effect of clavicular hook plate surgery is associated with complications such as subacromial synovitis, subacromial impaction, and subacromial surface wear. The Fixation of titanium plates with loops is Elastic Fixation. Its main therapeutic principle is to use loops and high-intensity risks to restore the stability of the coracoclavicular ligament and thereby maintain the reduction of the acromioclavicular joint. This surgical procedure can be performed under arthroscopy or, under the surveillance of image enhancement, through small incisions around the coracoid process for reduction and fixation. The results of the clinical report show that it has the advantages of small surgical trauma, reliable fixation, simple operation, and no need for secondary removal of internal fixation. Of course, titanium plates with loops also have complications such as bone tract fractures and loss of reduction. At present, there is still controversy over the clinical efficacy comparison of the two surgical methods in Rockwood type Ⅲ and type Ⅳ.

To compare the clinical efficacy of clavicular hook plates and titanium plates with loops in the treatment of Rockwood typeⅢ andⅣ acromioclavicular joint dislocation through a retrospective study.

A total of 55 patients with Rockwood type Ⅲ and Ⅳ who received clavicular hook plate or titanium plate with loop treatment at Tangshan Second Hospital and Tangshan People's Hospital from March 2020 to March 2023 were included. The operation time, joint function score, postoperative pain and complications of the patients were compared.

The average operation time of the loop titanium plate group was (61.67±6.60) minutes, which was significantly longer than that of the hook plate group (38.51±5.61) minutes (P<0.05). In terms of the postoperative VAS score, the group of the titanium plate with loops was (2.07±1.14) points, which was higher than that of the hook plate group (1.20±0.96) points (P<0.05). The assessment of shoulder joint function showed that the titanium plate with loops group with loops was significantly superior to the hook plate group in terms of range of motion in both forward flexion and elevation (142.16° vs 137.22°) and abduction and elevation (142.71° vs 106.31°) (P<0.05). The Constant-Murley score of the titanium plate with loops group (89.86±4.41) points was significantly higher than that of the hook plate group (73.43±6.63) points (P<0.05). In terms of complications, one case of reduction loss occurred in the titanium plate group with loops, while two cases of subacromial impaction and three cases of subacromial dissolution occurred in the hook plate group. The differences between the groups were statistically significant (P<0.05). There was no significant difference in intraoperative blood loss between the two groups [titanium plate with loops group (57.10±6.11) ml, hook plate group (53.90±5.57) ml, P>0.05].

The surgical method with loop titanium plate for treating Rockwood type Ⅲ and Ⅳ acromioclavicular joint dislocation is superior to the hook plate surgical method in clinical efficacy.

Proximal humeral fractures are a common type of fracture, accounting for approximately 4%-5% of all fractures. 86% of proximal humeral fractures occur in people over 50 years old. With population aging intensifying, the incidence rate is on the rise. People in this age group often have degeneration of the long head of the biceps tendon (LHBT), combined with fracture trauma factors, and the combined injury of LHBT is relatively common. This combined injury may affect surgical outcome and reduce patients' quality of life. Multiple clinical studies have confirmed that the incidence of LHBT injury is relatively high among patients with proximal humeral fractures. Histological studies further confirmed significant degeneration, neovascularization, and an inflammatory response in the LHBT of these patients. These pathological changes were closely related to pain symptoms, providing a theoretical basis for intraoperative tendon management. At present, many surgeons attempt to perform LHBT treatment simultaneously during proximal humeral fracture surgeries. However, there is still controversy regarding the impact of concurrent LHBT treatment on the recovery of shoulder joint function in patients after proximal humeral fracture surgery.

To evaluate the clinical effect of locking plate fixation combined with LHBT fixation in the treatment of Neer 3/4 partial proximal humeral fractures in patients over 50 years old, with a focus on the improvement of shoulder joint function and biceps brachii tendinopathy-related symptoms.

A retrospective analysis was conducted on patients over 50 years old with Neer 3/4 proximal humeral fractures who underwent locking plate internal fixation surgery from January 2022 to March 2024. Cases of open fractures, combined nerve injury, multiple fractures, as well as complications such as osteonecrosis, fracture resorption, humeral head collapse, and internal fixation failure after surgery were excluded. Ultimately, 75 patients were included in the analysis, among which 31 cases were in the LHBT fixation group (21 cases in the Neer 3 part and 10 cases in the Neer 4 part), and 44 cases were in the control group (31 cases in the Neer 3 part and 13 cases in the Neer 4 part). After the operation, the Constant-Murley score (CMS) was used to evaluate the function of the shoulder joint, and the Speed test was used to detect biceps brachii tendon lesions.

CMS of the fixation group (84.9±4.9) points was significantly better than that of the control group (81.8±6.3) points (P=0.024), mainly reflected in the pain score of the fixation group (12.2±1.9) points vs (11.1±1.8) points, P=0.015. The performance was better in the sub-items, while the improvement in activities of daily living, activity level and muscle strength was not significant (P>0.05). In terms of biceps brachii tendon symptoms, the positive rate of the Speed test in the fixation group was significantly lower than that in the control group (5/31 vs. 20/44, P=0.008) .

For patients over 50 years old with Neer 3/4 proximal humeral fractures, concurrent LHBT fixation during surgery can relieve shoulder joint pain, alleviate symptoms related to LHBT lesions, and, to a certain extent, indirectly promote the recovery of shoulder joint function.

Injury of the Long head of the biceps tendon (LHBT) is an important source of anterior shoulder pain, and its mechanism involves the interaction of multiple factors. LHBT originates from the superior glenoid tubercle and the superior labrum, and is a tendon divided into the internal and external segments of the joint. Its tendon sheath is closely connected to the rotator cuff. About 95% of LHBT injuries are related to rotator cuff tears and acromial impaction, and simple injuries are rare. Histological studies have shown that the nerve distribution to LHBT is uneven, with sensory and sympathetic nerve fibers densely distributed at the proximal end, which may be the direct neural basis of pain. The pathological mechanism of LHBT injury is complex. The main theories include: degeneration mechanism: Excessive exercise leads to the degeneration of collagen fibers and a decrease in the maximum load of tendons; Hourglass-like degeneration: Fusiform swelling of the tendon accompanied by mechanical compression, commonly seen in patients with massive rotator cuff tears; Abnormal morphology of internodule sulcus: Gleason PD et al. pointed out that an increase in groove width, a decrease in depth, and a reduction in the Angle of the inner wall would intensify the mechanical wear of LHBT during activity; The "Internal Impingement" theory: This theory holds that repeated overhead movements cause the humeral head to collide with the superior labrum, resulting in LHBT squeezing, wear and tear. Other factors: such as TNF-α and IL-1β mediating tenosynovitis; Pain-depression comorbidity mechanism: The lateral habenula mediates explosive neuronal discharges through T-type calcium channels, regulating chronic pain and mood disorders; Insufficient blood supply to the tendons, direct trauma, and injuries to the Pulley structure in the rotator cuff space (including supraspinatus tendons, subscapularis tendons, superior glenohumeral ligaments, and coracohumeral ligaments), etc. Imaging assessment is of vital importance in mechanism research: ①CT measurement: Widely used to analyze the morphology of the internodule sulcus. Abboud et al. confirmed that the width, depth of the groove, and the presence of bone spurs were associated with LHBT injury. Based on the CT data of patients with rotator cuff injury, Urita and Funakoshi et al. further found that those with LHBT injury tended to have narrower groove widths and greater groove depths. ②MRI measurement: The advantages of MRI technology in the diagnosis of LHBT injury are reflected in the following aspects: through innovative measurement indicators (coracobrachialis distance, coracoprocess overlap), precise positioning through image fusion, and AI automatic segmentation and risk prediction, the accuracy and efficiency of diagnosis have been significantly improved. Maria J. Leite et al., through the study of a large number of patients with rotator cuff injury, proposed that coracohumeral distance and coracoid overlap are effective MRI indicators for predicting LHBT injury and are helpful for clinical diagnosis; Lu Yi et al. proposed arthroscopic and MRI image fusion technology to accurately locate the injury range of LHBT, which is particularly suitable for complex cases of SLAP type Ⅳ injury combined with superior labrum barral handle tear. Artificial intelligence-assisted deep learning models (such as U-Net) automatically segment LHBT in MRI with an accuracy of 92% and can predict the tear risk area (tear risk increases by 3 times when the internodule groove Angle is >40°). LHBT, as the core source of anterior shoulder pain, its stability depends on the synergistic effect of the bony structure in the internodule sulcus and the Pulley complex (including the tendon sheath, the sickle ligament of the pectoralis major muscle, and the pulley structure). Studies have confirmed that over 90% of LHBT injuries are accompanied by rotator cuff lesions or joint instability, and are significantly associated with morphological variations in the intertuberous groove (width, depth, medial wall Angle, and bone spur formation). Although the "Internal Impingement" theory is widely accepted, traditional research has two limitations: reliance on cadaver specimens or two-dimensional image measurements, and the neglect of the dynamic biomechanical influence of the three-dimensional spatial configuration of the humeral head, coracoid process, and internodal groove. At present, clinical diagnosis is facing severe challenges. Conventional MRI has insufficient sensitivity (24.3%) for detecting LHBT injury, and the complex three-dimensional anatomical relationships of the shoulder joint make it difficult to explain the injury mechanism. It is particularly worth noting that previous studies have failed to answer the following key questions: ①How does the dynamic displacement of the humeral head affect the stress distribution of LHBT in the internodule sulcus? ② Does the spatial position variation of the coracoid process change the restraint efficiency of the pulley complex? ③ What is the synergistic effect rule of bony structure and soft tissue stability mechanism from a three-dimensional perspective?

To deeply explore the mechanism of positional changes of the scapula and humeral head in LHBT injury by constructing a three-dimensional (3D) model based on the scapular-humeral head and combining it with biomechanical principles.

The included research subjects were divided into three groups: Group A (complete rotator cuff injury group, 51 cases), Group B (incomplete rotator cuff injury group, 21 cases), and Group C (healthy control group, 24 cases), totaling 96 cases. All CT data of the shoulder joints were standardized. Three-dimensional models of the scapula and humeral head were constructed using Mimics and 3-matic. Based on the 3D model, measure the upward movement distance of the humeral head (HHUM), the position of the internodal groove (PIG), and the position of the coracoid process (PC). Using statistical analysis, the differences in general and measured parameters among groups were compared.

The average ages were as follows: Group A (58.59±8.03) years old, Group B (51.90±10.85) years old, and Group C (52.33±5.31) years old. HHUM: Group A was (8.08±2.13) mm, Group B was (7.18±1.41) mm, and Group C was (5.80±1.50) mm; PIG and PC: The PIG in group A was (48.67±9.08) °, and the innermost point, topmost point and bottommost point of PC were (21.88±3.30) mm, (29.24±4.48) mm and (19.24±4.65) mm, respectively. In group B, the PIG was (46.68±12.65) °, and the PC was (21.52±3.78) mm, (29.09±4.44) mm, and (18.85± 5.13) mm. In Group C, PIG was (52.39±10.95) °, and PC was (22.58±4.22) mm, (28.07±3.94) mm, and (18.25±4.79) mm. Statistical analysis indicated significant age differences (P<0.05) and HHUM values (P<0.05) among Group A, Group B, and Group C. In the PIG and PC measurement results, there were no statistical differences among the three groups (P>0.05) .

The distance of humeral head movement shows a positive correlation with the occurrence of rotator cuff tendon injury combined with LHBT injury. An increase in the degree of upward movement significantly increases the risk of combined injury. However, the location of the internodule groove and the anatomical landmark points of the coracoid process (the innermost, uppermost, and lowermost ends) have no significant association with LHBT injury. Furthermore, advanced age was identified as an independent risk factor for rotator cuff-LHBT compound injury, and its influence was significantly more substantial than that of gender or specific injury sites.