Surgical treatment of isolated post-traumatic subscapularis tendon ruptures

Objectives: We retrospectively evaluated the functional results of patients who were treated surgically for post¬traumatic isolated subscapularis tendon ruptures. Metho d s : The study included six patients (5 males, 1 female; mean age 63.3 years; range 53 to 70 years) who were operated on for isolated post-traumatic subscapularis ruptures. The mean interval between the development of symptoms due to trauma and operation was 4.3 months (range 1 to 9 months). Mechanism of injury, complaints, clinical findings, imaging methods, arthroscopic and surgi¬cal findings, repair techniques, and postoperative follow-up data were assessed. Evaluations were based on physical assessment, radiographic examination, and the UCLA (University of California at Los Angeles) score. The mean follow-up was 29.6 months (range 13 to 53 months). Results: The mean UCLA score was 11.3 (range 9 to 14) preoperatively. It increased to 25.8 (range 12 to 31) post-operatively (p<0.05). The results were good in four patients, fair in one patient, and poor in one patient. Magnetic resonance images obtained in five patients at the final follow-up showed total rupture in the patient with poor outcome, partial rupture in the patient with fair outcome, and maintenance of tendon integrity in the remaining patients. Conc lu s i o n : A careful clinical examination may enable the diagnosis of subscapularis tendon ruptures. Magnetic reso¬nance imaging may provide additional information. In most patients, the repair of the tendon is possible by proper pro¬tection of the axillary nerve and appropriate mobilization.