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
