Open repair of isolated traumatic subscapularis tendon tears

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Reconstruction

Background:

• Isolated traumatic subscapularis tendon tears are understudied regarding diagnosis, treatment, and outcomes.
• Limited research exists on the clinical management of these specific injuries.

Purpose of the Study:

• To evaluate the clinical outcomes of managing isolated traumatic subscapularis tendon tears.
• To assess the effectiveness of clinical tests, identify predictive outcome factors, and analyze return to sports after surgical repair.

Main Methods:

• A case series of 30 consecutive patients with isolated subscapularis tears (excluding HAGL lesions) treated with open reconstruction.
• Patients underwent assessment using the Constant score and specific subscapularis tests pre- and post-operatively.
• Postoperative tendon integrity was confirmed with imaging (ultrasound, MRI), and return to sports was evaluated.

Main Results:

• The Constant score significantly improved post-surgery (51.3 to 82.2).
• 90% of patients reported excellent or good outcomes, with 75% of athletes returning to their previous competition level.
• Postoperative subscapularis function was negatively correlated with preoperative fatty infiltration of the muscle.

Conclusions:

• Early surgical repair of isolated traumatic subscapularis tears yields favorable functional outcomes and a low re-rupture rate.
• Timely intervention is crucial, as surgical delay and preoperative fatty infiltration can compromise subscapularis function and recovery.