PDF herunterladen
CC BY-NC-ND 4.0 · Joints 2018; 06(01): 068-070
DOI: 10.1055/s-0037-1608952
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Isolated Subscapularis Tendon Tear in a Skeletally Immature Soccer Player

Paolo Avanzi
1   Division of Orthopaedics, Ospedale Sacro Cuore—Don Calabria, Negrar, Verona, Italy
,
Luca Dei Giudici
2   Clinical Orthopaedics, Università Politecnica delle Marche, DISCLIMO, School of Medicine, Ancona, Italy
,
Roberto Giovarruscio
1   Division of Orthopaedics, Ospedale Sacro Cuore—Don Calabria, Negrar, Verona, Italy
,
Antonio Gigante
2   Clinical Orthopaedics, Università Politecnica delle Marche, DISCLIMO, School of Medicine, Ancona, Italy
,
Claudio Zorzi
1   Division of Orthopaedics, Ospedale Sacro Cuore—Don Calabria, Negrar, Verona, Italy
› Institutsangaben
Weitere Informationen

Publikationsverlauf

15. Juni 2017

25. Oktober 2017

Publikationsdatum:
11. Dezember 2017 (online)

   Lizenzen und Reprints

Abstract

Subscapularis injury in adolescents, usually associated to an avulsion fracture of the lesser humeral tuberosity, accounts for less than 2% of all fractures of the proximal humerus. Isolated tears of the subscapularis tendon without a history of dislocation and associated avulsion fractures are an even rarer occurrence, and treatment is controversial. This article describes a rare case of a 12-year-old suffering from an isolated subscapularis tear and discusses its management. The patient was evaluated at presentation, and at 1 to 2.5 months after he underwent a cuff tear arthroscopic repair with a single “all suture” anchor loaded with two wires, active/passive range of motion (A/PROM), Constant–Murley score, and American Shoulder and Elbow Surgeons (ASES) score were noted. Patient reported an excellent outcome, recovered the whole ROM, was pain free, and returned to the previous level of activity. Isolated avulsion of the subscapularis tendon requires a high index of suspicion for a proper diagnosis as early treatment is required for a good recovery. Arthroscopy reserves more advantages in proper hands, restoring the previous levels of function and activity. An increase in attention for this condition is mandatory in a society where many adolescents are getting more and more active in high levels of sport activities.

Keywords

subscapularis - shoulder - arthroscopy - adolescent
 

  • References

  • 1 Tarkin IS, Morganti CM, Zillmer DA, McFarland EG, Giangarra CE. Rotator cuff tears in adolescent athletes. Am J Sports Med 2005; 33 (04) 596-601
    CrossrefPubMedSuche in Google Scholar
  • 2 Goeminne S, Debeer P. The natural evolution of neglected lesser tuberosity fractures in skeletally immature patients. J Shoulder Elbow Surg 2012; 21 (08) e6-e11
    CrossrefPubMedSuche in Google Scholar
  • 3 Vavken P, Bae DS, Waters PM, Flutie B, Kramer DE. Treating subscapularis and lesser tuberosity avulsion fractures in skeletally immature patients: a systematic review. Arthroscopy 2016; 32 (05) 919-928
    CrossrefPubMedSuche in Google Scholar
  • 4 Piasecki DP, Nicholson GP. Tears of the subscapularis tendon in athletes--diagnosis and repair techniques. Clin Sports Med 2008; 27 (04) 731-745
    CrossrefPubMedSuche in Google Scholar
  • 5 Heyworth BE, Dodson CC, Altchek DW. Arthroscopic repair of isolated subscapularis avulsion injuries in adolescent athletes. Clin J Sport Med 2008; 18 (05) 461-463
    CrossrefPubMedSuche in Google Scholar