To investigate the epidemiological and forensic characteristics of rotator cuff injuries caused by road traffic accidents, and to explore the timing and influencing factors of disability assessment of rotator cuff injuries. A retrospective analysis was conducted on 173 cases of rotator cuff injury caused by road traffic accidents. Factors analyzed included the time of post-injury assessment, the degree of functional loss of shoulder joint movement in six directions, the treatment methods, the presence or absence of combined shoulder injuries and the type of combined shoulder injuries, and the type of rotator cuff injury. The Kruskal-Wallis test and Wilcoxon rank sum test were used to analyze the differences in functional loss among the six directions of shoulder joint movement. The t-test was used to compare the differences in functional loss between the conservative treatment and the surgical treatment, as well as between cases with and without combined shoulder injuries. One-way analysis of variance (ANOVA) and Student-Newman-Keuls (SNK) test were used to analyze the differences in functional loss of shoulder joint movement among the injury types of contusion, mild tear, moderate tear and severe tear. One-way ANOVA and least significant difference (LSD) test were used to analyze the differences according to the number of involved rotator cuff tendons (1, 2, 3, or 4 tendons) and post-injury assessment time (3-<6 months, 6-<9 months, 9-<12 months, and ≥12 months). The median assessment time after injury was 290.00 days. Among the six directions of shoulder joint movement, statistically significant differences in the degree of functional loss were observed between abduction up, extension back and external rotation compared with adduction, as well as between external rotation and forward flexion up (P<0.05). There was no statistically significant difference in the degree of functional loss between conservative treatment and surgical treatment, or among different post-injury assessment times (P>0.05). However, there were significant differences between the non-combined shoulder injury and combined shoulder injury, different types of rotator cuff injuries, and the different numbers of involved rotator cuff tendons (P<0.05). Treatment methods had no significant effect on the degree of functional loss of shoulder joint movement, whereas combined shoulder injuries, more severe rotator cuff injuries, and involvement of a greater number of rotator cuff tendons were associated with more severe functional loss of shoulder joint movement. Rotator cuff injuries caused by road traffic accidents exhibit the epidemiological and forensic characteristics including delayed diagnosis after injury, prolonged post-injury assessment time, and the rotator cuff injuries being mainly mild to moderate tears (≤3 cm) and involving 1 or 2 tendons. Combined shoulder injuries are mostly characterized by greater tuberosity fractures of the humerus, long head of the biceps tendon injuries and shoulder dislocations. The recommended timing for disability assessment in cases involving rotator cuff tears and/or surgical treatment should be appropriately extended. The presence or absence of combined shoulder injuries, the types of rotator cuff injury, and the number of involved rotator cuff tendons should be emphasized in forensic clinical identification. 目的: 分析道路交通事故致肩袖损伤的流行病学及法医学特征，探索肩袖损伤的残疾等级评定时机和影响因素。方法: 从伤后鉴定时间、肩关节6个方向活动功能丧失程度、治疗方式、有无肩部复合伤及肩部复合伤类型、肩袖损伤类型等方面，对173例道路交通事故致肩袖损伤的案件进行回顾性分析。采用Kruskal-Wallis检验和Wilcoxon秩和检验分析肩关节6个方向活动功能丧失程度的差异性;采用t检验分析保守治疗和手术治疗、无肩部复合伤和肩部复合伤的肩关节活动功能丧失程度的差异性;采用单因素方差分析和Student-Newman-Keuls（SNK）检验对损伤类型（挫伤、轻度撕裂、中度撕裂、重度撕裂）的肩关节活动功能丧失程度进行差异性分析;采用单因素方差分析和最小显著性差异（least significant difference，LSD）检验分别对肩袖损伤累及肌腱根数（1、2、3、4根）和伤后鉴定时间（3~<6个月、6~<9个月、9~<12个月、≥12个月）肩关节活动功能丧失程度进行差异性分析。结果: 伤后鉴定时间的中位数为290.00 d。肩关节6个方向中，外展上举、后伸、外旋较内收方向，外旋较前屈上举方向的活动功能丧失程度差异具有统计学意义（P<0.05）。肩关节活动功能丧失程度在保守治疗和手术治疗、伤后不同鉴定时间之间的差异无统计学意义（P>0.05），无肩部复合伤和肩部复合伤、肩袖损伤不同类型之间、肩袖损伤累及不同肌腱根数之间的差异均有统计学意义（P<0.05）。治疗方式对肩关节活动功能丧失程度无影响，肩部复合伤、肩袖损伤重、累及肩袖肌腱根数多可加重肩关节活动功能丧失程度。结论: 道路交通事故致肩袖损伤具有伤后确诊时间滞后，伤后鉴定时间长，肩袖损伤以轻、中度撕裂（≤3 cm）和累及肌腱以1、2根为主，肩部复合伤以肱骨大结节骨折、肱二头肌长头肌腱损伤和肩关节脱位居多等流行病学和法医学损伤特点，涉及肩袖撕裂和（或）手术治疗案件的残疾等级评定时机建议适当延长，有无肩部复合伤、肩袖损伤类型、肩袖损伤累及肌腱根数可作为法医临床鉴定时重点考量的方面。.
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