Year Book: Isolated Rupture of the Tendon of the Subscapularis Muscle

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Clinical Features in 16 Cases. Gerber, C. Krushell, RJ. University of Berne, Switzerland. Abstract/Commentary:|1992 Year Book of Orthopedics. Article 2-34.|Original Article:|J Bone Joint Surg. 1991. 73B. pp 389-394.. Background.--Few cases of isolated subscapularis tendon rupture have been reported. Sixteen patients with a characteristic clinical syndrome that had not been described previously were assessed. Patients.--The patients were 16 men aged 25-64 years. Traumatic rupture of the tendon of the subscapularis muscle was documented as an isolated lesion in the shoulder. The injury was caused by forceful hyperextension or external rotation of the adducted arm. The men complained of anterior shoulder pain and weakness of the arm when used above and below the shoulder level. None of the men had shoulder instability. The injured shoulders displayed increased external rotation and decreased strength of internal rotation. The lift-off test, a simple clinical maneuver, reliably diagnosed or clinically excluded relevant subscapularis tendon rupture. The clinical diagnosis was best confirmed by either ultrasonography or MRI; however, arthrography and CT arthrography also were useful. In each patient, surgical exploration confirmed the diagnosis. Ruptured tendon repair was technically demanding and required good exposure to identify and protect the axillary nerve (Fig 2-8).