John D Polousky1, Samuel Harms. 1. Rocky Mountain Hospital for Children, Rocky Mountain Youth Sports Medicine Institute, Centennial, CO, USA. johnpolousky@msn.com
Abstract
BACKGROUND: Although shoulder injuries in adolescents are relatively common, injuries to the rotator cuff are relatively rare and not well characterized in the literature. We review 2 cases of adolescent subscapularis tendon avulsions treated surgically. METHODS: The 2 patients were high-level athletes, 1 is a baseball pitcher and the other is a boxer. Both were injured during participation in their respective sports. In each case, the diagnosis was made by magnetic resonance imaging. Patients underwent an open repair by a deltopectoral approach, using suture anchors for fixation. RESULTS: After surgery both patients regained full range of motion and returned to their previous levels of activity. Both patients scored 30 and 35 on the American Shoulder and Elbow Surgeons and University of California, Los Angeles shoulder instruments, respectively. CONCLUSIONS: Subscapularis tendon injuries in adolescents are rare. Diagnosis requires careful attention to the physical examination and imaging. A positive lift-off test, belly-press test, or increased passive external rotation should prompt an early magnetic resonance imaging. Good results and return to previous levels of activity can be achieved with open repair. LEVEL OF EVIDENCE: IV.
BACKGROUND: Although shoulder injuries in adolescents are relatively common, injuries to the rotator cuff are relatively rare and not well characterized in the literature. We review 2 cases of adolescent subscapularis tendon avulsions treated surgically. METHODS: The 2 patients were high-level athletes, 1 is a baseball pitcher and the other is a boxer. Both were injured during participation in their respective sports. In each case, the diagnosis was made by magnetic resonance imaging. Patients underwent an open repair by a deltopectoral approach, using suture anchors for fixation. RESULTS: After surgery both patients regained full range of motion and returned to their previous levels of activity. Both patients scored 30 and 35 on the American Shoulder and Elbow Surgeons and University of California, Los Angeles shoulder instruments, respectively. CONCLUSIONS: Subscapularis tendon injuries in adolescents are rare. Diagnosis requires careful attention to the physical examination and imaging. A positive lift-off test, belly-press test, or increased passive external rotation should prompt an early magnetic resonance imaging. Good results and return to previous levels of activity can be achieved with open repair. LEVEL OF EVIDENCE: IV.
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